
Class JRi^lLS. 
Book _b± 



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COPYRIGHT DEPOSIT, 



MATERIA MEDICA FOR NURSES 



THE MACMILLAN COMPANY 

MEW YORK • BOSTON • CHICAGO • DALLAS 
ATLANTA • SAN FRANCISCO 

MACMILLAN & CO., Limited 

LONDON • BOMBAY • CALCUTTA 
MELBOURNE 

THE MACMILLAN CO. OF CANADA, Ltd. 

TORONTO 



MATEEIA MEDICA 

FOR NURSES 



// BY 

A5S. >LUMGARTEN, M. D. 

INSTRUCTOR IN MATERIA MEDICA AT THE GERMAN HOSPITAL 
TRAINING SCHOOL FOR NURSES, NEW YORK 



5fom fork 
THE MACMILLAN COMPANY 

1914 

All rights reserved 



.B'6 



Copyright, 1914, 

By THE MACMILLAN COMPANY 

Set up and electro typed. Published May, 1914 



MAY 21 1914 



/ 



©CI.A374158 



Jtt Mtmatvxm 

TO MY FATHER 

WHOSE PATERNAL LOVE AND SYMPATHY HAS 

BEEN A CONSTANT INSPIRATION TO 

THE AUTHOR 

THIS BOOK IS AFFECTIONATELY DEDICATED. 



PREFACE 

The modern nurse is no longer merely the gentle attendant at 
the sick bed, able to perform only a few practical duties, but she is 
now also a watchful trained observer; of symptoms of disease, of the 
development of complications, and of the effects of drugs and their 
poisonous symptoms. In this capacity, and because of her con- 
stant presence at the bedside, she is of inestimable value to the 
physician in the management of the complex and often treacherous 
phenomena of disease. 

The object of this text book is to develop intelligent, trained ob- 
servers of the effects of drugs and to enable the nurse to administer 
medicines accurately. The majority of text books for nurses are 
entirely too technical, with the result that the nurse learns a great 
many technical terms without gaining a clear idea of the changes 
that drugs produce in the functions of the human body. An at- 
tempt is therefore made to present the subject in a strictly peda- 
gogic manner, to teach facts, not words, and always to proceed 
from the known to the unknown. The new matter presented is 
based throughout upon facts previously explained. The phar- 
macological action is arranged in a simple, concise manner to facili- 
tate the remembrance of the text. The numerous tables scattered 
throughout the book are intended to correlate the facts already 
learned; for example, a table of Cardiac Stimulants follows the 
discussion of the drugs in this group; a table of comparative actions 
follows that of the Atropine group, etc. 

It is also essential that, before taking up the changes which drugs 
produce in the action of the body, the nurse have some idea of the 
normal action of the body. For this reason there have been scat- 
tered through the text numerous notes on Normal Physiology wher- 
ever it was felt to be necessary to a clear understanding of the drugs 
presented, since the arrangement of the curriculum in most training 
schools is such that Physiology is often studied at a later time than 
Materia Medica. 

The nurse has ample opportunity, in the wards, to observe the 
effects of drugs on actual patients; but she does not benefit from 
this opportunity because her observation is untrained. It is to 



viii PREFACE 

assist and train her observation that the descriptions of the 
"Appearance of the Patient" are inserted in the text. This en- 
ables the nurse to compare the effects of a particular drug, given 
to an individual patient, with the standard description of that 
drug as given in the text. 

Little attention is given to therapeutics; as the nurse should 
never treat, but administer and observe. It is occasionally im- 
portant, however, that in administering certain potent drugs she 
should have some idea of the reason for such administration, to 
aid her in the observation of their effects. Short notes on the use 
of some of the important drugs are therefore inserted. 

The chapter on " Solutions" deals with this very important sub- 
ject at great length, because the proper and accurate administra- 
tion of drugs, and the preparation of accurate solutions, is of prime 
importance to the nurse. Most of the rules for the calculation of 
solutions given in the text are entirely original and have been 
found in actual practice to be the easiest and simplest. This chap- 
ter also contains many helpful tables, such as " Saturation Points," 
"Usual Strengths of Standard Solutions," etc. 

This book is perhaps larger than many texts on this subject but 
this is due to the inclusion in the text of the following features 
usually not dealt with: the chapter on "Solutions"; the chapter 
on "Prescription Reading," a subject required by most State 
Boards; and particularly by the inclusion, among the preparations, 
of most of the "New and Non-Official Remedies" in common use. 
Many of these substances are extensively used, and it is the nurse 
who has to administer them. Where is she to find the action and 
preparations of these drugs if not in her text book? 

The classification of the drugs is based upon their therapeutic 
use since the nurse learns their action in this way. They are ar- 
ranged in two distinct groups: "Stimulants" and "Depressants," 
and then according to the particular organs of the body they prin- 
cipally affect. 

I desire to express my sincere thanks to Dr. Richard Stein and 
Dr. Norbert Stadtmueller for their careful examination of the 
proofs; and to Miss Anna L. Schulze, R. N., former Superintend- 
ent, and Miss Elizabeth P. Lindheimer, R. N., the present Superin- 
tendent of the German Hospital Training School for Nurses, New 
York, for valuable suggestions. 

I avail myself of the opportunity to acknowledge the use, as 
references, of the following works: "Pharmacology and Thera- 
peutics," by A. R. Cushny; "Therapeutics, Its Principles and 



PREFACE ix 

Practice/' by H. C. Wood; " Essentials of Materia Medica and 
Therapeutics/ ' by Henry Morris; "New and Non-Official Rem- 
edies/' 1913 edition, of the American Medical Association; and to 
notes on the Lectures on Pharmacology delivered by Dr. W. A. 
Bastedo at the College of Physicians and Surgeons (Columbia 
University), New York. 

A. S. Blumgarten. 
1114 Madison Ave., 
New York. 



TABLE OF CONTENTS 

PAGE 

Preface vii 

CHAPTER I 
Introduction <, . . . 1 

CHAPTER II 
Systems of Measurement 16 

CHAPTER III 
Prescription Reading 24 

CHAPTER IV 
Solutions 31 

CHAPTER V 
Classification 53 

PART I— GASTERO-INTESTINAL STIMULANTS 

CHAPTER VI 
Gastric Stimulants 69 

CHAPTER VII 
Intestinal Stimulants (Cathartics) 96 

PART II— STIMULANTS ACTING AFTER 
ABSORPTION 

CHAPTER VIII 
Blood and Circulatory Stimulants 127 

CHAPTER IX 

Respiratory Stimulants .-.-.. . 192 

xi 



xii CONTENTS 

CHAPTER X 
Drugs which Stimulate the Nervous System 215 

CHAPTER XI 
Alteratives 290 

CHAPTER XII 
Secretory Stimulants 304 

CHAPTER XIII 
Uterine Stimulants 314 

CHAPTER XIV 
Diuretics 331 

PART III— DEPRESSANTS 

CHAPTER XV 
Cardiac and Vascular Depressants 345 

CHAPTER XVI 
Respiratory Depressants 364 

CHAPTER XVII 
Cerebral Depressants 371 

CHAPTER XVIII 
Depresso Motors 460 

PART IV— SPECIFICS 

CHAPTER XIX 
Specifics 471 

PART V— DRUGS ACTING CHEMICALLY 

CHAPTER XX 
Acids and Alkalies ' 517 



CONTENTS xiii 

CHAPTER XXI PAGE 

Astringents 538 

PART VI— LOCAL REMEDIES, SERUMS AND 
ORGANIC SUBSTANCES 

CHAPTER XXII 
Antiseptics and Local Remedies 567 

CHAPTER XXIII 

Serums, Vaccines and Organic Substances 618 

Index 629 



MATERIA MEDICA FOR NURSES 



MATERIA MEDICA FOR 
NURSES 



CHAPTER I 



INTRODUCTION 



Materia Medica is the study of the substances used in 
treating the sick. Most of these substances are drugs, while 
many of them are serums, solutions of bacteria, or extracts 
of organs. 

The subject is divided into three distinct branches. 

Materia Medica proper, or pharmacognosy, which deals 
with the botanical, chemical and physical properties of 
drugs. 

Pharmacology or pharmacodynamics, which is the study 
of the action, or the effects of drugs; that is, the study of 
the changes which drugs produce in the activities of the 
body, or of its organs. 

Therapeutics, which deals with the treatment of disease 
by drugs. 

For the nurse, only the first two branches of Materia 
Medica are of importance, as she is never called upon to 
treat patients, nor should she ever do so without orders from 
a physician. She should know, however, the properties 
and effects of drugs, for the physician relies upon her to 
see that their proper effects are obtained, and that no unusual 
or poisonous symptoms occur. When these do occur, she 
should be able to recognize them at the earliest possible 
moment. 

Drugs are obtained from the mineral, vegetable, or animal 
kingdoms. Those that are obtained from the vegetable 
kingdom, are made from various parts of plants, such as 
the roots, the bark, the flowers or the fruit. In some in- 
stances the sap, or even the entire plant is used. 

l 



2 MATERIA MEDICA 

From the crude plant, various preparations are made, so 
as to be able to regulate the strength, or measure the dose 
of the drug more accurately; in some instances to make the 
drug more palatable, or to disguise its unpleasant taste. 

The following is a list of the more commonly used prepara- 
tions. 

SOLID PREPARATIONS 



Common name 


Latin name 


Common name 


Latin name 


Powder 


Pulvis 


Cerate 


Ceratum 


Pill 


Pilula 


Confection 


Confectio 


Capsule 


Capsula 


Ointment 


Unguentum 


Tablet 


Tabella 


Plaster 


Emplastrum 


Cachet 


Cachet 


Sterule 


Sterula 


Lozenge 


Trochiscus 


Lamella 


Lamella 


Vescette 


Vescette 


Suppository 


Suppositorium 


Extract 


Extractum 


Paper 


Charta 


Resin 


Resina 








FLUID PREPARATIONS 




Common name 


Latin name 


Common name 


Latin name 


Infusion 


Infusum 


Spirit 


Spiritus 


Fluidextract 


Fluidextractum Wine 


Vinum 


Tincture 


Tinctura 


Mixture 


Mistura 


Solution 


Liquor 


Vinegar 


Acetum 


Water 


Aqua 


Mucilage 


Mucilago 


Emulsion 


Emulsum 


Oleate 


Oleatum 


Syrup 


Syrupus 


Oleoresin 


Oleoresina 


Glycerite 


Glyceritum 


Liniment 


Linimentum 


Decoction 


Decoctum 







DEFINITIONS OF PREPARATIONS 



Solid Preparations 

Powder: A crude drug ground up in the form of a powder 
and used in this form. 

Pill: A pill is a drug moulded in the form of a very small 
sphere. Pills should always be fresh, for when they are ex- 
posed to the air, they may become so hard, that they cannot 



INTRODUCTION 3 

be dissolved by the juices of the stomach or intestine, and 
they then produce no effects. 

Capsule: A drug made up in a small cylindrical gelatin 
container which disguises the taste of the contained sub- 
stance. 

Tablets are dried powdered drugs which have been com- 
pressed into small discs. They are usually prepared in an 
aseptic manner so that they can be given hypodermically. 
They are very easily dissolved. 

Cachets are small disc-like pieces of rice paper which 
are stuck together, enclosing between them the drug to be 
administered. 

Lozenges are flat discs consisting of a drug made up with 
sugar or tragacanth. 

Vescettes are effervescent salts compressed into a 
tablet. 

Extract: An extract is a solid preparation obtained by 
dissolving the drug in alcohol or water, and then evaporating 
the solution. The resulting sediment is the extract, and is 
usually about four or five times as strong as the crude drug 
itself. 

Resins are gummy substances which can be dissolved in 
alcohol, but not in water. 

Cerates are preparations of drugs made up with white wax. 

Confections are preparations of drugs made up to dis- 
guise the taste of unpleasant tasting substances. They are 
usually made up with honey and sugar. 

Ointments are preparations which are applied to the skin 
and are melted by the heat of the body. The drugs which 
they contain are then absorbed by the skin. They are 
usually made up with lard, vaseline, or oils. 

Plasters are preparations which are made up with resins, 
wax or lead plaster, and are then spread upon coarse muslin 
or white leather. They are applied to the skin, the 
mixture of the drugs which they contain is dissolved by the 
heat of the body, and the drugs are then absorbed by the 
skin. 

Sterules are glass capsules containing a sterile solution of a 
drug. They are used for hypodermic administration. 



4 MATERIA MEDICA 

Lamellae are small gelatin discs containing medicinal 
substances, which are inserted between the lower eyelid and 
the eyeball. 

Papers are small pieces of paper impregnated with medic- 
inal substances. 

Suppositories are cone-shaped preparations of a drug 
made up with cocoa butter. 

LIQUID PREPARATIONS 

Infusions are preparations of plant drugs made by pouring 
hot or cold water over them, and then letting the drug steep 
for some time. The strength of an infusion depends on how 
much of the drug is used to a definite quantity of water. 

Fluidextracts : Fluidextracts are preparations of plant 
drugs made by first making an extract of a drug and then 
dissolving this extract in alcohol or water in such quantities, 
that the resulting fluid contains 100% of the drug. It is 
therefore just as strong as the crude drug itself, but is in 
fluid form. 

Tinctures are preparations of plant drugs, or other 
substances which do not evaporate easily, dissolved in a 
fluid other than water or glycerin. They are usually dis- 
solved in alcohol and are now mostly 10% in strength. By 
a tincture, we usually mean an alcoholic solution unless the 
fluid in which the drug is dissolved is specially mentioned. 
For example, ammoniated tincture means a solution of a 
drug in ammonia water; while an ordinary tincture means a 
weak alcoholic solution. 

Solutions are drugs dissolved in water. Solutions usually 
contain substances which do not evaporate easily. 

Waters are solutions of substances which evaporate very 
easily. 

Emulsions are solutions of oily substances which contain 
the oil divided up into fine globules. They are usually of a 
milky color and consistency. 

Elixirs are palatable preparations of drugs. They are 
made up with alcohol, sugar and some aromatic substance. 
They usually contain very smali quantities of the drug. 



INTRODUCTION 5 

Syrups are preparations of drugs made with sugar and 
water. 

Glycerites are preparations of drugs dissolved in glycerin. 

Decoctions are preparations of plant drugs made by boil- 
ing them in water and then straining the fluid. 

Spirits are preparations of volatile substances in al- 
cohol. 

Wines are preparations of drugs dissolved in wine. 

Mixtures are preparations consisting either of several 
drugs mixed together, or a fluid containing a substance which 
does not dissolve. 

Vinegars are medicinal substances dissolved in a weak 
solution of acetic acid, or vinegar. 

Mucilages are gummy drugs dissolved in water. 

Oleates are medicinal substances dissolved in oleic acid, 
which is an ingredient of many oils and fats. Oleates are 
more easily absorbed than ointments. 

Oleoresins are extracts of plant drugs obtained by dis- 
solving them in ether. They usually consist of a mixture 
of a resin, and an oil which evaporates easily (volatile oil). 
They are very concentrated preparations. 

Liniments are liquid or soft preparations of drugs which 
are applied by rubbing on the skin. The drug is usually dis- 
solved in alcohol or in an oily substance. 

OFFICIAL AND UNOFFICIAL PREPARATIONS 

In order that all drugs should be uniformly prepared, 
and a standard set for the strengths of the different prepara- 
tions, a committee of physicians and pharmacists is appointed 
in every country to regulate the strengths and preparations 
of all the drugs used in medical practice. This committee 
publishes a book known as the Pharmacopoeia, which con- 
tains a list of all the preparations of drugs whose ingredients, 
strengths and methods of preparations are up to a cer- 
tain standard. Such preparations are called official prepara- 
tions, and often have the letters, U. S. P. (United States 
Pharmacopoeia), B. P. (British Pharmacopoeia), etc., written 
after them. Some preparations may be official in one 



6 MATERIA MEDICA 

country and not in another, though they may be used in 
both countries. 

UNOFFICIAL PREPARATIONS 

Since the Pharmacopoeia committee revises the Phar- 
macopoeia only once in ten years, and since many drugs 
and preparations are discovered in the meantime, many of 
which may be extensively used during that time, though 
they are not described in the Pharmacopoeia, these drugs 
are called unofficial preparations. Many of the unofficial 
preparations are accepted by the Pharmacopoeia com- 
mittee as being up to a certain standard in strength, in- 
gredients and action, at their next revision, and these drugs 
then become official preparations. 

Other unofficial preparations may not be accepted by 
the Pharmacopoeia committee, though they may be ex- 
tensively used. 

The National Formulary and United States Dispensatory, 
are private unofficial books containing a list of both official 
and unofficial preparations, their ingredients, preparations, 
and their methods of preparation. 

ACTIVE PRINCIPLES 

It was formerly thought that certain plants cured disease 
because of magic or supernatural powers which these plants 
possessed; and unless certain formalities were complied 
with, in obtaining these drugs, they were not supposed to 
have any curative effect. 

For example, in obtaining the drug hyoscyamus (henbane) 
it was necessary that the drug be dug up with certain pre- 
cautions, and addressed as follows: 

" Sacred herb, I summon thee to the house (of my patient) 
to stop the Rheum of his feet, etc. I conjure thee by the great 
name Jaoth Sabaoth." We now know that this drug has 
certain active principles (the alkaloids, atropine, hyoscya- 
mine, hyoscine) which cause its effects. 

In gathering other drugs it was necessary to " Delve round 
the root and take it up with thy two hands turned upward; 



INTRODUCTION 7 

and sing over it nine paternosters, and in the ninth, at the 
words l Deliver us from evil' snap it up," etc., or it was neces- 
sary to mention the name of the sick man and his father, 
etc., etc. 

We now know, however, that all drugs (particularly, the 
plant drugs) cause changes in the activity of the body by 
virtue of certain chemical substances which they contain. 
These principles contained in the plant, and which if extracted 
from the plant, produce the same effects as the crude drug 
itself, are called active principles. 

The most important active principles are of two kinds, 
alkaloids and glucosides. 

Alkaloids 

An alkaloid is an active principle, found in plant drugs 
or made chemically, which acts like an alkali. (An alkali 
is a chemical substance which combines with acids to form 
salts. It turns red litmus paper blue). Alkaloids also com- 
bine with acids to form salts, and their salts have the same 
effects as the alkaloids themselves. 

For example, when sodium, an alkali, is added to sul- 
phuric acid, a salt, sodium sulphate, is formed. 

When morphine, an alkaloid, is added to sulphuric acid, 
a salt, morphine sulphate, is formed. 

The alkaloids have a definite chemical composition, but 
they do not dissolve readily in water. The salts which they 
form, however, dissolve very easily in water, and are princi- 
pally used to produce the effects of the alkaloids. 

Glucosides 

A glucoside is the active principle of a plant drug, which, 
when it is decomposed into simpler substances, for example 
by the action of an acid, one of the simple substances thus 
formed is always glucose (grape sugar), or another sugar. 
The other substance formed is usually an aromatic substance. 

Chemical Action 

Drugs belonging to the mineral kingdom usually act by 
combining chemically with some of the body secretions, or 



8 MATERIA MEDICA 

if they are salts, they are absorbed as such, and then they 
may act like an alkaloid, or physically, according to the laws 
of physical chemistry. 

ADMINISTRATION 

Drugs produce two kinds of effects; local or general effects. 
They may produce changes in an organ or tissue of the 
body if applied directly to that organ or tissue. The effect 
which is then produced is called a local effect. 

They may enter the blood stream, and then affect one or a 
number of organs in their travels through the circulation of 
the blood. The effect then produced is called a general effect. 

A drug may enter the blood stream through the skin, 
through the mucous membranes of various organs, such as 
the lungs, the stomach, the intestines or the rectum. It 
may be injected directly into a vein, into a muscle, or under 
the skin, and the drug then finds its way into the blood from 
these tissues. 

LOCAL ADMINISTRATION 

To obtain a local effect, drugs are applied in the following 

forms : 

Solutions 

Liniments 

Oleates 

Cerates 

Powders 

Lozenges 

Bougies 

Suppositories 

Plasters 

Ointments 

Solutions, Oleates and Liniments are applied to various 
regions of the body, in the form of wet dressings. In the 
mouth or mucous membrane lined cavities, solutions are 
applied as mouth washes or irrigations. 

Powders are applied directly to the surface of the body, 
as a spray. 



INTRODUCTION 9 

Lozenges are kept in the mouth, they are dissolved by the 
saliva, and the medicinal substances which they contain 
then produce their effect. 

Bougies are long thin medicated tubes, made with wax. 
They dissolve in mucous membrane lined cavities, and then 
produce either local or general effects. 

Suppositories are cone-shaped preparations of drugs made 
with cocoa butter, and are applied in the same manner 
as bougies. 

Plasters are usually applied on the surface of the body 
which is to be affected, and they are then left on for about 
fifteen minutes to a half hour. 

Ointments are rubbed on the skin and produce either a 
general or local effect* For local effect they may be spread 
on a piece of gauze or lint and applied directly to the surface. 

GENERAL EFFECTS 

To produce general effects, a drug must enter the blood 
stream. 

The most rapid way that a drug can enter the blood 
stream, is by being injected directly into a vein. 

METHOD OF GIVING AN INTRAVENOUS INJECTION 

The median basilic, or median cephalic vein of the front 
of the elbow is used, as the most suitable vein for in- 
jection. A rubber or gauze bandage is tightly wound around 
the middle of the arm, the hand is gripped firmly, and the 
forearm is extended. This makes the vein stand out promi- 
nently. The surface of the skin over the vein is sterilized 
with green soap, 50% alcohol and 1-2000 bichloride of 
mercury, or the site may be painted with tincture of iodine. 

A hypodermic syringe (sterilized) is then filled with a 
sterile solution of the drug to be injected, the air is expelled 
from the syringe and the needle is then inserted into the vein, 
pointing it towards the heart, and the blood slightly aspi- 
rated from the vein. If blood is aspirated from the vein and 
enters the syringe you are sure the needle is in the vein. 



10 MATERIA MEDICA 

The bandage at the arm is then loosened, and the solution 
of the drug is injected very slowly. It is very important to 
inject drugs into the vein slowly, the slower it is in- 
jected, the safer is the injection. Serious effects, at times 
fatal, have resulted from too rapid injections. 

The effect of a drug after an intravenous injection ap- 
pears immediately. 

Another method of injecting a drug into the blood, is 
by dissolving it in normal saline solution and giving it by 
means of an intravenous infusion. 



METHOD OF GIVING AN INTRAVENOUS INFUSION 

The arm is prepared as for an intravenous injection, the 
fluid is prepared in a special glass jar, which is placed on a 
stand above the level of the patient. The fluid is then 
allowed to run through a rubber tube attached to either a 
special cannula to fit into the vein, or to a specially con- 
structed needle. If the needle is used, it is inserted directly 
into the vein. If the cannula is used, the vein must be ex- 
posed, opened, and the cannula inserted into it in a direc- 
tion towards the heart. 

Recently a method has been devised for administering 
a specific drug for syphilis, Salvarsan, in this manner. 

A new method of anaesthetizing patients has been recently 
devised, where the anaesthetic is dissolved in the saline 
solution and administered as an intravenous infusion. 

METHOD OF GIVING AN INTRAMUSCULAR INJECTION 

This is another method to cause rapid absorption and 
therefore rapid effects. 

The sites for such injection, are usually in the buttocks, 
and the front of the thighs. 

The skin is sterilized by washing it with green soap, 
alcohol and bichloride of mercury 1-2000, or it is painted 
with tincture of iodine. A large syringe is used with a firm 
needle. This is inserted perpendicularly into the skin, the 
syringe is then removed, or the site for injection is aspirated, 



INTRODUCTION 11 

to see if the needle has been stuck into a large vessel. If 
blood oozes from the needle, another site must be chosen. 
If there is no blood oozing through the needle, the solution 
may be injected, but very slowly, and the site of injection 
should be thoroughly massaged afterwards. The site of in- 
jection is then covered over with collodion or some other 
dressing. 



METHOD OF GIVING A HYPODERMIC INJECTION 

The skin at the site of injection is usually sterilized with 
alcohol. The syringe is filled with a sterile solution of the 
drug to be administered, the skin is then taken up between 
the thumb and index finger of the left hand, and the needle 
is inserted under the skin at an angle of about forty-five 
degrees, and the solution slowly injected. The skin at the 
site of the injection is^then thoroughly massaged. 

Care must be taken to insert the needle under the skin, 
not into the skin, in which case the skin looks like goose 
skin, and the needle should be withdrawn. 

The best sites for injections, are the front of the thighs, 
the arms and forearms. 

The effects appear in about ten minutes to a half hour 
after injection, depending on how good the patient's circula- 
tion is. 

METHODS OF GIVING DRUGS FOR ABSORPTION FROM 

THE SKIN 

To administer drugs for absorption from the skin, it is 
necessary to rub the drug thoroughly on the skin in such a 
manner that it will not evaporate very easily. For this pur- 
pose ointments are used. These must be rubbed thoroughly 
over a large surface, to get the greatest amount of absorption. 
As the pores of the skin become clogged up with the oint- 
ment after continued use, the ointment is usually rubbed in a 
different region of the body every day. For example, on 
one thigh one day, on the other, the next day; then it is 
rubbed on the arms, then on the chest, finally on the back. 



12 MATERIA MEDICA 

This is called a course of rubbings, or inunctions. In apply- 
ing potent drugs in the form of rubbings, the nurse should 
protect her hands from absorbing the drug by using old 
kid gloves, or by rubbing the ointment with a piece of 
chamois. 

Another method of applying drugs to the skin for absorp- 
tion is by means of vapor. The patient sits in a closed cabi- 
net, the head protruding from the top, while underneath 
the chair the drug to be given is burnt, the fumes being 
absorbed by the skin. 

INTERNAL ADMINISTRATION 

The most common way of administering drugs, however, 
is to let the patient drink or swallow them. The drug is dis- 
solved in the stomach or intestines, if it is not already in a 
fluid form. It is then absorbed by the mucous membrane of 
the stomach or intestine, and enters the blood stream in this 
manner. 

Many drugs are given by the rectum, in cases where it 
may not be possible, or when it is harmful to give them by 
the stomach. In such cases they are given in the form of 
suppositories, which are inserted into the rectum, the cocoa 
butter dissolves, and the contained drug goes through the 
mucous lining of the rectum into the blood stream. 

Drugs may also be given by a rectal enema, or even 
better, by allowing it to run in drop by drop in saline 
solution through a catheter attached to an apparatus ar- 
ranged at the side of the bed, the pressure of which can be 
easily regulated (Murphy Method). 

TIME OF ADMINISTRATION 

With some exceptions, it is not of very great importance 
whether a drug is given before or after meals. 

As a rule, drugs which increase the appetite or which in- 
crease the secretion of the stomach or intestines should be 
given before meals. 

Those that are given to neutralize excessive secretions 



INTRODUCTION 13 

in the stomach, or those that are harmful (irritating) to the 
stomach should be given after meals. 

DOSAGE 

All drugs are poisons — they are harmful to the individual; 
in fact they may even cause death if given in sufficiently 
large quantities. 

The harm to the individual is done by causing an over- 
activity of some, or of all the organs of the body (over stimu- 
lation, irritation), or by lessening the activity of an organ or 
several organs to a very marked degree (depression). It is 
by taking advantage of these activities of drugs, that they 
can be used in the treatment of disease. The difference, how- 
ever, between beneficial and poisonous or dangerous effects, 
is simply due to the difference in the amount of drug that is 
used. 

By experiments on animals, it can be determined how little 
of a drug can be given in order to produce any change in 
the activity of an organ, or the activity of the body: — such 
an amount is called the minimum or smallest dose. By 
similar experiments we can find out how large an amount of 
a drug can be given without producing any dangerous effects. 
This amount is called the maximum dose. If larger quanti- 
ties than the maximum dose are given, we get poisonous 
or dangerous symptoms — such a dose is called an over- 
dose, or poisonous dose. 

The doses of different drugs are different ; some drugs may 
be found to have accidentally the same dose. 

Conditions Influencing the Dose of a Drug 

There are certain conditions which influence the dose of a 
drug. 

(1) Age : An older person usually needs a larger dose than 
a younger one. 

(2) Sex: Males usually require larger doses than females. 

(3) Weight: Heavier, stouter individuals, usually require 
larger doses than lighter individuals. 

(4) Temporary Conditions: After a meal there is usually 



14 MATERIA MEDICA 

less absorption than before, the effects are therefore not as 
marked. 

(5) Time of Administration: For example, some drugs, 
such as those which produce sleep, may produce little effect 
in the morning, and more marked effect in the evening. 

(6) Pregnancy, Lactation, and Menstruation are factors 
which occasionally cause changes in the activity of certain 
drugs. 

Young's Rule for Dosage 

To determine the dose of a drug to be administered to a 
child, we fill in the known amounts in the following formula, 
and then calculate it. The result is the fraction of the adult 
dose to administer. 

Young's Rule: Age of the child, divided by (age + 12) 
= the fraction of the adult dose, or 
age 

of adult dose. 

age + 12 

For potent drugs, a slightly smaller quantity should be 
administered, and for some drugs a slightly larger dose 
should be administered. 

Example: How much Aspirin should be given to a child 
of 3 years old. Adult dose of Aspirin = grs. 5 

Age of child = 3 

3 3 1 

then, - — - - 

3+12 15 5 

We therefore give the child £ of (grs. 5) or gr. 1 of Aspirin. 

IDIOSYNCRASY 

There are some individuals who get unusual or opposite 
effects, others who get even poisonous effects, from ordinary 
doses of some drugs. There are others, upon whom even 
larger doses of some drugs produce no effect at all. Such 
people are said to have an idiosyncrasy against a particular 
drug. 

There are two kinds of idiosyncrasies. 



INTRODUCTION 15 

(a) Idiosyncrasy of Effect: Those that get opposite, un- 
usual or poisonous effects from small or ordinary doses of 
drugs. 

(b) Idiosyncrasy of Dose: Individuals who get no effect 
at all from ordinary, or even large doses of certain drugs. 

For example, morphine is a drug which usually produces 
sleep and quiets the patient. There are some people in 
whom it may cause excitement and keep them awake. 

Another example, is one in whom even larger doses of 
morphine produce no effect at all. 



CHAPTER II 

SYSTEMS OF MEASUREMENT 

There are two systems of measuring drugs. One is the 
French or Metric System, the other is the English or Apothe- 
caries' System. 

The Metric System is the one which is used in all European 
countries, and has the advantage, that the units are divided 
into tenths, that the units of length, volume and weight 
are similar, and that the units of volume are equal to the 
units of weight. 

In this country, the Apothecaries' System is still used, 
but it is gradually being superseded by the Metric System, 
and it is simply a question of time when the Apothecaries' 
System will be abandoned entirely. 

THE METRIC SYSTEM 

The elementary unit of measurement in the Metric System 
is the one for length. This is the meter, which is about one 
ten-millionth part of the distance from the equator to the 
north pole. It is equal to about 39.37 inches and is written 
as 1.0 

TABLE OF LENGTH 

The unit is 1.0 one meter 
one tenth of it is 0.1 one decimeter 
0.01 one centimeter 
0.001 one millimeter 



a u a 
a u a 



TABLE OF SURFACE 

A surface one meter long and one meter wide is called a 
square meter 1.0 sq. m. 

The unit is 1.0 one square meter 

one tenth of it is 0.1 one square decimeter 
" " " " 0.01 one square centimeter 
" " " " " 0.001 one square millimeter 
16 



SYSTEMS OF MEASUREMENT 17 

TABLE OF VOLUME 

A volume one meter long, one meter wide, and one meter 
high, is one cubic meter. 

1.0 one cubic meter 

0.1 one cubic decimeter 

0.01 one cubic centimeter 

0.001 one cubic millimeter 

TABLE OF WEIGHTS 

The unit of measurement for weight, is the gramme, which 
is the weight of one cubic centimeter of water at a tempera- 
ture of 4 degrees centigrade, written 

1.0 one gramme 

one tenth of it is 0.1 one decigramme 

" " " " 0.01 one centigramme 

" " " " 0.001 one milligramme 

Units greater than one gramme are given definite names. 

ten times 1.0 1 gramme 

is equal to 10.0 1 decagramme 

ten times that is 100.0 1 hectogramme 

a « a u looao i kilogramme 

Since 1.0 (one gramme) is the weight of 1 cubic centimeter 
of water, in referring to fluids, we call the denomination 1,0, 
one cubic centimeter; 2.0, two cubic centimeters (2 c.c), etc. 

TABLE OF CAPACITY 

For measuring fluids, the unit of measurement is the litre, 
which is the amount of water at 4 degrees centigrade con- 
tained in a volume of one cubic decimeter, or the capacity 
of one kilogramme of water at 4 degrees centigrade. 

One litre = 1000 grammes, or since 

1000 grammes occupies 1000 
cubic centimeters of space 
One litre = 1000 c. c. which is the unit of 
capacity 



18 i MATERIA MEDICA 

One tenth of that is 1 decilitre = 100 c.c. or 1 hectogramme. 
" " " " " 1 centilitre = 10 c.c. or 1 decagramme. 
" " " " " 1 mililitre = 1 c.c. or 1 gramme. 

The terms deca, hecto and kilo, we apply to quantities 
ten, one hundred or one thousand times respectively greater 
than the litre. 

To overcome the difficulty of remembering the denom- 
inations of the Metric System, it will be facilitated, if we 
remember that the figures to the left of the decimal point, 
correspond to dollars, in our coinage system; and to grammes 
in the Metric System. The figures to the right of the 
decimal point, correspond to dimes, cents and mills re- 
spectively, in our coinage system, and to decigrammes, centi- 
grammes and milligrammes in the Metric System. 

For example: $1.53 is one dollar and fifty-three cents in 
our coinage system, and if we write it without the dollar 
sign, in the Metric system of Measuring Weights, we call it, 
one gramme and fifty-three centigrammes. 

APOTHECARIES* WEIGHT MEASUREMENT 

The unit of measurement is the grain, which is equal to 
0.065 (sixty-five milligrammes) in the Metric System. The 
grain is written gr. i. 

20 grains = one scruple 3 

3 scruples or 60 grains = one drachm 5 

480 grains or 8 drachms = one ounce 5 

5760 grains or 12 ounces = one pound lb. 

FLUID MEASUREMENT 
Table of Capacity 

The unit of measurement is the minim, which is equal to 
0.065 cubic millimeter. It is written m i. 

60 minims = one fluid drachm 5 

8 fluid drachms = one ounce § 

16 ounces = one pint O 

2 pints = one quart qt. 

4 quarts or 8 pints = one gallon gal. 



SYSTEMS OF MEASUREMENT 



19 



TABLE OF EQUIVALENTS 

Value of Metric Units in Apothecaries' Units 





Grain 


Drachm 


Ounce 


Pound 


One milligramme . . . 


0.01543 


0.00026 






One centigramme . . . 


0.15432 


0.0026 


0.00032 




One decigramme. . . . 


1.54324 


0.0257 


0.0032 


0.00027 


One gramme 


15.43236 


0.257 


0.03215 


0.00270 


One kilogramme .... 


15432.3564 


257.206 


32.1508 


2.6792 



APPROXIMATE EQUIVALENTS OF METRIC UNITS 

Weight 

■fa of a grain 



One milligramme 
One centigramme 
One decigramme 
One gramme 



i of a grain 
1^- grains 
15| grains 

(in prescriptions 15 grains) 



One kilogramme = 32 ounces or 2| pounds 



Capacity 

One cubic millimeter c. m. m. = H minims 

= 15 minims 

= 34 ounces or 2^ pints (or ap- 
proximately) one quart 



One cubic centimeter c. c. 
One litre 



APPROXIMATE EQUIVALENTS OF APOTHECARIES' 

UNITS 

Weight 

One grain = 0.06 (six centigrammes) 
One drachm = 4.0 (4 grammes) 
One ounce = 30.0 (30 grammes) 

Capacity 

One minim = 0.06 of a cubic centimeter 

One drachm = 4.0 c.c. (4 cubic centimeters) 

One ounce = 30.0 c.c. (30 cubic centimeters) 

One pint = 500.0 c.c. (500 cubic centimeters) 

One quart = 1000.0 c.c. (one litre) 



20 



MATERIA MEDICA 



APPROXIMATE EQUIVALENTS OF METRIC UNITS 
COMMONLY USED IN PRESCRIPTIONS 



2.0 

1.0 

0.6 

0.3 

0.2 

0.1 

0.06 

0.03 

0.015 

0.008 

0.004 

0.0032 

0.0027 

0.0022 

0.0016 

0.0013 

0.0011 

0.001 

0.0006 

0.0005 

0.0004 

0.0003 

0.0001 



2 grammes) 

1 gramme) 

6 decigrammes) 

3 decigrammes) 

2 decigrammes) 
1 decigramme) 

6 centigrammes) 

3 centigrammes) 

15 milligrammes) 
8 milligrammes) 

4 milligrammes) 

32 decimilligrammes) 
27 decimilligrammes) 
22 decimilligrammes) 

16 decimilligrammes) 
13 decimilligrammes) 
11 decimilligrammes) 

1 milligramme) 

6 decimilligrammes) 

5 decimilligrammes) 
4 decimilligrammes) 
3 decimilligrammes) 
1 decimilligramme) 



= 30 
= 15 
= 10 
= 5 
= 3 

= ll 

= 1 



i 
i 

iw 

1 

A 
A 

_JL 
1 2D 

-2DTT 
DD7T 



grams 

grains 

grains 

grains 

grains 

grains 

grain 

grain 

grain 

grain 

grain 

grain 

grain 

grain 

grain 

grain 

grain 

grain 

grain 

grain 

grain 

grain 

grain 



PRACTICAL MEASUREMENT OF UNITS 
To measure the Minim m i or 0.06 (6 centigrammes) 

The minim is not exactly equal to the drop. There are 
many medicine droppers in practical use, from which each 
drop that is expelled, is approximately equal to one minim. 

By a drop, is usually meant the drop which falls from the 
mouth of a bottle when it is held horizontally. Two or two 
and a half of such drops, are approximately equal to one 
minim. 

To measure the Drachm 5i or 4.0 (4 grammes) 

The Drachm is equal to a level teaspoonful of either a 
fluid or a solid preparation. 



SYSTEMS OF MEASUREMENT 21 

Two drachms or 8.0 (8 grammes) are contained in a 
level dessertspoonful. 

Four drachms, or half an ounce, or 16.0 (16 grammes) 
are equal to a level tablespoonful. 

Eight ounces, or 240.0 (240 grammes) are contained in 
a full tumbler. 

TABLE OF APPROXIMATE EQUIVALENTS 

One drachm or 4.0 ( 4 grammes) = one teaspoonful 

Two drachms or 8.0 ( 8 grammes) = one dessertspoonful 
Four drachms or 16.0 ( 16 grammes) = one tablespoonful 

half an ounce 
Eight ounces or 240.0 (240 grammes) = one tumblerful 

METHOD OF REDUCING METRIC DENOMINATIONS TO 
APOTHECARIES' DENOMINATIONS 

Rule 1. Multiply the Metric quantity by 15; which gives 
the number of grains or minims, and reduce the result to its 
lowest terms. 

(Since 1.0 is equal to 15 grains or 15 minims) 

Example: Reduce 1.03 (1 gramme and 3 centigrammes) 
to the Apothecaries' denominations. 

Since 1.0 =15 grains 

1.03 = 15 X 1.03 = 15.45 grammes 15 ^\\ = 15i grs. 

Example : Reduce 64.0 gms. to its Apothecaries' equivalent. 

Since 1.0 = 15 grains 
64.0 = 64 x 15 = 960 grains 

Since there are 480 grains in one ounce, in 960 grains there are 
960 -5- 480 = 2 ounces, written 5ii 

Rule 2. To reduce very small Metric quantities (less than 
0.06) to their Apothecaries' equivalents. 

Write the Metric quantity as the numerator of a fraction, 
of which the denominator is always 0.06 (six centigrammes), 
and reduce the fraction to its lowest terms. The result is 
the fraction of a grain. 



22 ' MATERIA MEDICA 

Example: Reduce 0.0004 (4 decimilligrammes) to its 
Apothecaries' equivalent. 

Since 0.06 (six centigrammes) is equal to 1 grain, 

0.0004 (4 decimilligrammes) is equal to 

0.0004 , 

of a gram = 









0.06 


00004 
00600 


4 
~ 600 = 


1 

= gram. 

150 





0.0004 (4 decimilligrammes) is equal to grain. 



METHODS OF REDUCING APOTHECARIES' UNITS TO 
THEIR METRIC EQUIVALENTS 

Rule 1. Reduce the quantity to grains and divide the result 
by 15. The result is the number of grammes. 

Since 15 grains = 1.0 (1 gramme) 

Example: Reduce 2 drachms 3ii to their equivalent 
Metric units. 

2 drachms = 2 x 60 or 120 grains 
120 + 15 = 8 
5ii, 2 drachms = therefore, 8 grammes 

When larger quantities are dealt with, the following 
method is easier. 

Rule 2. Reduce the quantity to drachms and multiply by 4. 

Since 1 drachm = 4.0 (4 grammes) 

Example: Reduce 5 ounces $v to its metric equivalent. 

Since 1 drachm = 4.0 (4 grammes) 
5 ounces therefore = 160.0 (160 grammes) 

Rule 3. Another simple method of reducing Apothecaries* units 
to Metric Units, is to reduce the quantity to grains and multiply 
the result by 0.065 (65 centigrammes). 

(Since 1 gramme = 0.065) 

Example: Reduce 1 drachm and a half 3iss to its metric 
equivalent. 



SYSTEMS OF MEASUREMENT 23 

One drachm and a half = 90 grains 

Since one grain = 0.065, 90 grains will equal 

90 x 0.065 = 5.85 (5 grammes and 85 centigrammes) 

Rule 4. For very large quantities reduce the amount to ounces 
and multiply the result by 30. 

Since one ounce = 30.0 (30 grammes) 
Example: Reduce 40 ounces to its metric equivalent. 
Since one ounce = 30.0 (30 grammes) 
40 ounces = 40 X 30.0 = 1200.0 grammes. 

Rule 5. To reduce fractional amounts of Apothecaries' units 
to their metric equivalents, multiply the fraction by 0.06 (six 
centigrammes), and divide the denominator into the numerator. 

The result is the number of grammes the fraction is equal 
to. 

Example : Reduce T fa grain to its metric equivalent. 

Since 1 grain = 0.06 (six decigrammes) 

grain = — x 0.06 - 100 ' ' 



100 100 0.0006 

— grain = 0.0006 (six decimilligrammes). 

Example : Reduce -fa grain to its metric equivalent. 

Since 1 grain = 0.06 

1 . , 1 A nfl OCA 1 0.06 

gram is equal to — X 0.06 = 250 



250 250 0.00028 

— grain = 0.00028 (28 centimilligrammes). 



CHAPTER III 

PRESCRIPTION READING 

It is important for the nurse to be able to read prescrip- 
tions, as she is occasionally ordered to administer a medicine, 
the ingredients of which are written in the form of a prescrip- 
tion. 

Every prescription consists of four parts: 

1. The Superscription 

2. The Inscription 

3. The Subscription 

4. The Signature 

1. The superscription consists of the date, and the name 
of the patient, which are written at the top, (occasionally 
the name of the patient is written at the lower right hand 
corner) and the symbol R which stands for the Latin word 
recipe, meaning "take thou." It is also a symbol of the 
God Jupiter, and is a relic of the days, when all prescriptions 
were begun with a prayer to Him, invoking His divine aid 
in making the ingredients more efficacious. 

2. The inscription consists of the names and the amounts 
of the ingredients used. 

The names are written in Latin, usually in the genitive 
case, for example, Camphora (genitive, Camphorae). 

The most important ingredient in the prescription is 
written first, and is often called the basis. 

The next most important ingredient is called the adju- 
vant, and is written next. 

The next substance written, is usually the one which 
disguises the taste of the mixture, such as a syrup, and is 
often called the corrigent or corrective. 

The last substance written, is the one in which all the 

24 



PRESCRIPTION READING 



25 



others are dissolved, and it is often called the vehicle, excip- 
ient or menstruum. 

The amounts of the ingredients are written in the Metric 
or Apothecaries' system of measurement. 

In the metric system, the units used are the gramme, 
decigramme, centigramme, milligramme, etc. 

In the apothecaries 7 system, the units used are the drachm, 
grain, minim, etc. They are written in the Arabic symbols. 
Roman numerals being used however, for the numbers, 
unless the quantity is a fraction, in which case the Arabic 
numerals are used. 



Example 



5v 

grs. xx 

3ix 

5i or gj 

Oiii 

3ss 

gr- 



lit 



= 5 drachms 
= 20 grains 

= 9 scruples 

= 1 ounce 

= 3 pints 

= \ drachm 

= T ^ grain 



The abbreviation ss is for the Latin word semis, meaning 
half. 

3. The subscription consists of the directions to the drug- 
gist for compounding the prescription. These are usually 
written in Latin. 

Certain abbreviations are commonly used in the subscrip- 
tion. The most common ones are 



quantum sumcit (as much as may be necessary) 
quantum sumcit ad (as much as may be necessary to) 
misce (mix) 

F. fiat, (singular) used when only one ingredient is written. 
F. fiant (plural) when many ingredients are used. 



q. s. 
q. s. ad 
m. 



F. 


= fiat. 


= make 


D. 


= dentur 


= give 


Div. 


= divide 


= divide 


caps. 


= capsulas 


= capsule 


pii. 


= pilulas 


= pill 


chart. 


= chartas 


= powder 


tab. 


= tabellas 


= tablet 



26 MATERIA MEDICA 

tab. trit. = tabellas triturates = tablet triturates 



troch. 


= trochisci 


= lozenges 


supposit. 


= suppositoria 


= suppositories 




tales 


= such 


dos. 


= doses 


= doses 


ad. scat. 


= ad scatulam 


= in the box 




pone in scat. 


= put in a box 




cochleare 


= spoon 



cochleare parve = teaspoon 

The following are the most common Latin verbs used in 
prescriptions. 



adde 


= add 


bulliat 


= boil 


cola or colator 


= strain 


filtra 


- filter 


solve 


= dissolve 


tere 


= rub 


tere bene 


= rub well 



The following are the most common adjectives used 

aequalis = equal 
aa. = partes aequalis = equal parts 

bulliens = boiled 

fervens = hot 

saturatus = saturated 

magnus = large 

parvus = small 

The signature is usually written at the end of the pre- 
scription and consists of the directions to the patient. It 
always begins with the abbreviation S. meaning signa = 
mark (on the label). 

The quantities to be administered are written in their 
Metric or Apothecaries' equivalents, for example, a teaspoon 
is written 4.0 or 5i. 

A dessertspoon, is written 8.0 or 5h\ 

The following are the abbreviations used in the signature, 
and their definitions. 

It is important for the nurse to know them, as her orders 
are often written with these abbreviations. 



PRESCRIPTION READING 27 

gtt. = gutta = drop 

A. M. = morning 

p. M. = evening 

o. d. = omne die = daily 

o. m. = omne mane = every day 

o. n. = omne nocte = every night 

m. et. n. - mane et nocte = day and night 

t. i. d. = ter in die =3 times a day 

b. i. d. = bis in die = twice a day 

q. i. d. = quatuor in die = four times a day 

(not to be given at night) 

q. h. = quaqua hora = every hour 

q. 2 h. = quaquae duo horae = every 2 hours 

q. 3 h. = quaquae tres horae = every 3 hours 

When medicines are ordered to be given q. 2h. or q. 3h. 
etc. they must always be given at night also. 

stat. = statum = at once, immediately 

s. o. s. = si opus sit = if necessary 

This refers to only one dose. More than one dose should 
not be given if a medicine is ordered s. o. s. 

p. r. n. = pro re nata = when required 

(as often as necessary) 

When a drug is ordered p. r. n. the nurse may use her 
judgment in giving more than one dose. 

a. c. = ante cibum = before meals 
p. c. = post cibum = after meals 

At the end of the prescription, the physician's name is 
written. 

EXAMPLES OF PRESCRIPTIONS OF FLUID MEDICINE 

May 17, 1905 



For 


Mr. John Jones 








R 


Magnesii Sulph. 
Magnesii Carb. 






3ii 




Spiritus Ammoniae Aromat. 


aa 


3i 




Aqua destil. q. s. 


ad. 




51 


M. 


et. Sig. 5i t. i. d. 














Dr. Brown 



28 MATERIA MEDICA 

In this prescription, the superscription is the R and Mr. 
John Jones. 

The inscription is the mixture of the ingredients, of which 
the magnesium sulphate is the most important, magnesium 
carbonate next of importance, while the distilled water is 
the excipient or menstruum. 

The directions to the pharmacist are simply to mix the 
ingredients together (misce); and the directions to the 
nurse to administer one teaspoonful of it three times a 
day (t. i. d.). 

May 5, 1904 



For Mr. Bates 




R 




Bismuthi Subnitr. 


15.0 


Mucilago Acaciae 


10.0 


Syr. Simplex 


5.0 


Aqua Cinnamomi q. i 


?. ad. 60.0 


Misce et. Sig. 3i q- i- d. 






Dr. Jameston 



This prescription reads: 
For Mr. Bates — 

Take thou, of bismuth subnitrate 15 grammes, of muci- 
lage of acacia 10 grammes, of simple syrup, 5 grammes, and 
add enough cinnamon water to make up 60 grammes. Mix 
the ingredients together and give the patient one teaspoon- 
ful of the mixture three times a day. 

This is a very good method of prescription writing. 

If the mixture is made up in a two ounce bottle, the number 
of grains of each ingredient, in every teaspoonful, is the 
same as the number of grammes of each ingredient in the 
entire mixture; since there are 60 grains in each drachm or 
teaspoonful dose, and there are 60 grammes in a two ounce 
bottle. 

For Example: In the above prescription we can see at 
once that each teaspoonful dose of the mixture contains 
15 grains of bismuth subnitrate, 10 grains of mucilage of 
acacia, etc. 



PRESCRIPTION READING 29 

Example 

June 5, 1900 
For Mr. Winsley 
R 

Extracti Colocynthidis Compositi 5ss 
Rheii grs. xxiv 

m. et divide in pilulae No. XII 
Sig. one o. n. 

Dr. Jamestain 

This prescription reads: 

Take thou, of compound extract of colocynth 2 drachms, 
and of rhubarb 24 grains, mix them together, and divide 
the mass into twelve pills. Each pill therefore contains T V 
of the whole amount, or 10 grains of the compound colocynth 
powder and 2 grains of the rhubarb. 

Example 

April 7, 1899 
For Mr. Hestar 
R 

Tab. Morphinae Sulph. aa 0.015 
D. tales dos. No. XX 

Dr. Sesley 

This prescription reads, take thou of morphine sulphate 
tablets, each to contain 0.015 (15 milligrammes). Give 
twenty such doses. 

Example 

May 17, 1895 
For Mr. Hillston 
R 

Pyramidon 0.1 
Phenacetine 0.2 
Caffeine 0.06 

Sacch Lact. 0.3 
D. tales dos. No. XX et. pone in scat. 
M. et. fiant. in chart. 
Sig. one t. i. d. 

Dr. Lestertan 



30 MATERIA MEDICA 

This prescription reads : 

Take thou, of pyramidon 1 decigramme, of phenacetine 
2 decigrammes, of caffeine 6 centigrammes, and of milk 
sugar 3 decigrammes. Mix the ingredients together into a 
powder, and put twenty such powders in a box. Give one 
three times a day. 



CHAPTER IV 

SOLUTIONS 

A solution is a liquid containing particles of a solid, gas 
or another liquid, so finely divided, that this dissolved sub- 
stance cannot be seen, and the fluid seems to be of one color 
and consistency. 
A substance may be dissolved in water, alcohol, ether, 
glycerin, etc. They are then called alcoholic, ethereal solu- 
tions etc. (see preparations). 

By the strength of the solution is meant, the amount of 
a substance that is dissolved in the fluid. For example — by 
a five per cent silver nitrate solution, we mean that 100 
parts of a certain fluid contain five parts of silver nitrate, 
(5 grammes of silver nitrate for every 100 grammes of water). 
The strength of a solution is often spoken of as a 1 to 1000 or 
1 to 1500 solution. 

In the Apothecaries' System, we often speak of the strength 
of a solution as the number of grains to the ounce. For 
example — a solution of zinc sulphate containing five grains 
to the ounce, etc. 

SATURATION 

When a fluid contains as much solid or gaseous matter as 
it can hold, it is said to be saturated with that substance. 
Such a solution is called a saturated solution. If more of 
that substance is added to the solution, it will not be dis- 
solved, but remain undissolved as a sediment. 

The saturation point of different substances, varies; 
with some it is 5%, with others 50%, with others 100% etc e 

The strength of a saturated solution varies with the 
fluid in which a substance is dissolved. For example: the 
saturation point of silver nitrate in water is 65%, in alcohol 
it is 4%. 

31 



32 



MATHK1A MKOICA 



TABLE OF SATURATION POINTS OF COMMONLY USED 
SOLUTIONS FOR LOCAL USE 





Sat. Point 


Sat. Point 


Sat. Point 


Sat. Point 


Name of Solution 


la 


in boiling 


in 


in 




Wat or 


Water 


Alcohol 

insoluble 


Glycerin 


Alum 


10% 


80% 


freely 




when warm 


Pon.oie Void 


0.4% 
7% 


6% 
33% 


30% 

25% 




Bichloride of Mercury 


7% 


Boric Acid 


•V" 


25% 


: r ' r 


20% 

All pro- 


Carbolic Acid 


8% 


All pro- 


All pro- 






port ions 


port ions 


portions 


Cocaine 


0.2% 


Decom- 
posed 


L7% 




Cocaine Hydrochloride. . 


70% 


Decom- 
posed 


40% 




Gallic Acid 


1% 




20% 


8% 


Lead Acetate 


30% 


50% 


f> 




Potassium Bicarbonate, . 




Decom- 
posed 


insoluble 




Potassium Carbonate, , . 


50% 


70% 


insoluble 




Potassium Chlorate 


6% 


40% 


slightly 

soluble 




Potassium Permanganate 


6% 


o-C- 

£0 Q 


Decom- 
posed 




Silver Nitrate 


65% 


90% 
66?! 


4% 

insoluble 




Sodium Borate 


5% 


50% 


Sodium Bicarbonate. . . . 


8% 


Decom- 
posed 


insoluble 




Sodium Carbonate 


- 1 ' 


35% 


insoluble 




Sodium Chloride 


26% 


30% 


insoluble 


.... 


Tannic Acid 


75% 


verv solu- 
ble 


30% 




Zinc Sulphate 


65% 


83% 


insoluble 






SOLUTIONS 



33 



TABLE OF SATURATION POINTS OF COMMONLY USED 
SOLUTIONS FOR INTERNAL ADMINISTRATION 





Sat. Sol. 


Sat. Sol. 


Sat. Sol. 


Sat. Sol. 


Name of Solution 


in 


in boiling 


in 


in 




Water 


Water 


Alcohol 


Glycerin 


Ammonium Carbonate . . 


20% 


Decom- 
posed 






Ammonium Chloride. . . 


33% 


50% 


2% 


17% 


Ammonium Bromide . . . 


45% 


53% 


7% 




Ammonium Iodide 


62% 


70% 


10% 


.... 


Calcium Oxide 


0.1% 


0.06% 


insoluble 




Hydriodic Acid 


10% 


All pro- 


All pro- 








portions 


portions 


.... 


Lithium Bromide 


62% 


70% 


very solu- 
ble 




Magnesium Sulph 


54% 


88% 


insoluble 


.... 


Methyl Salicylate 


slightly 


very 


very 


.... 


Potassium Acetate 


71% 


More solu- 
ble 


33% 




Potassium Bicarbonate. 


25% 


Decom- 
posed 


insoluble 




Potassium Bitartarate . . 


0.5% 


5% 


slightly 


.... 


Potassium Bromide. . . . 


50% 


50% 


0.5% 




Potassium Citrate 


66% 


very 


slightly 




Potassium Iodide 


100% 


100% 


8% 


30% 


Potassium and Sodium 










Tartarate. . . 


45% 
10% 


50% 
Decom- 


insoluble 




Quinine Bisulphate 


5% 


5% 






posed 






Quinine Hydrochloride. . 


100% 


Decom- 
posed 


62% 


11% 


Quinine Salicylate 


1% 


Decom- 
posed 


8% 


6% 


Quinine Sulphate 


0.1% 


Decom- 
posed 


1% 


3% 


Salicylic Acid 


0.3% 


6% 


33% 

4% 




Sodium Acetate 


50% 


All pro- 








portions 




.... 


Sodium Bicarbonate .... 


8% 


Decom- 
posed 


insoluble 




Sodium Citrate 


50% 


71% 


slightly' 






34 



MATERIA MEDICA 



TABLE OF SATURATION POINTS OF COMMONLY 
USED SOLUTIONS FOR INTERNAL ADMINISTRA- 
TION— Continued 





Sat. Sol. 


Sat. Sol. 


Sat. Sol. 


Sat. Sol. 


Name of Solution 


in 


in boiling 


in 


in 




Water 


Water 


Alcohol 


Glycerin 


Sodium Bromide 


50% 


55% 


7% 


.... 


Sodium Iodide 


100% 


100% 


25% 


.... 


Sodium Salicylate 


55% 


very solu- 
ble 


15% 




Strontium Bromide 


50% 


70% 


very solu- 
ble 




Sodium Sulphate 


26% 


Decom- 
posed 


insoluble 


soluble 


Sodium Phosphate 


15% 


Decom- 
posed 


insoluble 


.... 



RULES FOR MAKING SOLUTIONS 

The nurse is often called upon to make up solutions of 
drugs, differing in strength from those she has in stock, or to 
administer doses of drugs from stock solutions of various 
strengths. 

The following rules are methods for calculating the 
amounts to be used. These methods are based upon simple 
arithmetic, and are of great assistance in making up accurate 
solutions, or to administer an accurate dose of a drug. 



RULES FOR MAKING UP SOLUTIONS OF DIFFERENT 
STRENGTHS FROM STOCK SOLUTIONS OF KNOWN 
STRENGTHS 

Rule 1. To find out in how much water to dissolve a tablet of 
known strength to make up a solution of a required strength. 

Example : In how much water would you have to dissolve 
a, 0.3 gm. tablet (grs. 5) of bichloride of mercury, to make 
up a solution of 1-2000 strength. 

Let X = the number of cubic centimeters of water to be 
used ; then the tablet has the same proportion to the number 



SOLUTIONS 35 

of cubic centimeters of water to be used, as 1 is to 2000, or, 
writing it in the form of a proportion, 

0.3 : X :: 1 : 2000 

In any proportion the outer numbers are called extremes, and 
the inner numbers are called means. 

The extremes in this example are 2000 and 0.3 
" means " " " " X and 1 

Since in any proportion, the product of the means is always 
equal to the product of the extremes, 

we find that the number of c.c. or 

X = 0.3 x 2000 = 600. cubic centimeters 

We would have to dissolve the tablet in about 600 cubic 
centimeters of water, or approximately one pint. 

Therefore, to find out the number of cubic centimeters 
of fluid in which to dissolve a tablet of known strength, we 
write the example in the following manner. 

The tablet in stock, is to the amount of water to be used, 
(represented by X) as the proportion of the drug to water in the 
required strength, or 

Tablet : X :: drug : water (in required strength) 
X being the amount of water to be used 

Example: How much water is to be used in making up 
a solution of 1-5000 bichloride of mercury with a tablet of 
bichloride of mercury of 7| grains. 

1. Reduce grs. 1\ to its metric equivalent 
Since gr. i = 0.06 (six centigrammes) 

7 \ grs. = 1\ X 0.06 = 0.45 (centigrammes) 
then 

0.45 :X :: 1 : 5000 

X = therefore 0.45 X 5000 = 2250 cubic centimeters 
2250 cubic centimeters = 2 quarts and half a pint 
(1000 cubic centimeters = 1 quart) 

Rule 2. To find out the quantity of drug to be used to make up 
a required amount of a given strength of solution. 

Rule : The amount of drug to be used (represented by X) has 



36 MATERIA MEDICA 

the same proportion to the known quantity to be made up, as the 
proportion of drug is to water in the required strength, or, writ- 
ing this formula in the form of a proportion, 

X (the amount of drug to be used) : the quantity to be made 
up:: the amount of drug: water (in the required strength) 

Example: How much potassium chlorate would be neces- 
sary to make up one pint of a 4% potassium chlorate solu- 
tion. 

One pint = 500 cubic centimeters, 4% = 4 : 100 
Let X = the amount of drug to be used, then 
X: 500:: 4: 100 

Again, the product of the extremes is equal to the product 
of the means. 

Extremes are, 100 and X 
Means are 4 and 500 
therefore, 100 X = 4 X 500, or 2000 
or X =20 grammes 

20 grammes of potassium chlorate would then have to 
be added to 500 grammes of water (1 pint) to make up a 
4% solution. 

In the above examples, it is important to reduce all the 
quantities used, to the metric units; as apothecaries' units 
cannot be multiplied by metric units. For example, it is 
impossible to multiply grains by grammes or cubic centi- 
meters. 

The problems can be worked out in the apothecaries' 
units if all the known quantities are reduced to the same 
apothecaries' unit. 

Example: How much boric acid would be necessary to 
make up one quart of a 2% solution. 

1. Reduce all the quantities to the apothecaries' units, 
preferably to grains or minims. 

One quart = 15360 minims 

A 2% solution is approximately 10 grains to the ounce 
(480 grains equals one ounce). A 2% solution is approxi- 
mately 10 : 500 or 1 : 50 then 



SOLUTIONS 37 

Let X = the number of grains to be used, then 

X : 15360 ::1 : 50 or 
50 X = 15360 grains 
X = 50 1 15360 

307 grains 
307 grains = 5 drachms (since 1 drachm = 60 grains) 

To find the amount of water to be used in Rule 1, (in 
the apothecaries' units), the same method may be used, re- 
ducing the known quantities to their apothecaries' units, 
however. It is much simpler however, to reduce the known 
quantities to the metric units, and solve the problem as shown 
in examples 1 and 2. 

Rule 3 To find the amount of a stock solution of known 
strength to use in making up a solution of a known different 
strength. 

Example : How much of a 1% bichloride of mercury solution 
must be used to make up 500 c.c. or 1 pint of a 1 to 2000 
solution. The stock solution in this problem is the 1% 
bichloride of mercury solution. 

If we represent the amount of stock solution to use by X, 
then the amount of drug to be used, has the same proportion 
to the amount of solution to be made up, (in this case 500 
c.c.) as the proportion of drug to water in the required 
strength (in this case 1 to 2000); since the 500 c.c. must 
contain 1 part of bichloride of mercury to 2000 c.c. of water. 

This example, written in the form of a proportion is: 

X : 500 :: 1 : 2000 

This proportion would be true, if the stock solution were 
of full strength or 100%; but since it is only a 1% solution 
and contains only T ^ part of the drug, the amount of 
stock solution is only T ^ of X, then the proportion is: 

— X : 500 :: 1 : 2000 
100 

In this proportion the means are 1 and 500, and the ex- 
tremes, ifo X, and 2000. 



38 MATERIA MEDICA 

Since in every proportion, the product of the means is 
always equal to the product of the extremes, then, 
1 



100 



X x 2000 m 500 x 1 



or X = — x — X 500 X 1 
2000 1 

(Since, when we divide an equation or proportion by the 
numbers on one side of the equation, these numbers become 
inverted on the other side; thus 2000 becomes Wot, t-qh be- 
comes M* etc. 

Therefore X = — = 25 

4 

25 c.c. of the 1% solution of bichloride of mercury will 
then have to be added to 500 c.c. of water to make up the 
1 to 2000 solution. 

To make the calculation of the amount easier, however, 
we find by this method of proportion, that X, or 

The amount of stock solution to use, in making up a definite 
quantity of one solution from another, is always equal to: 

The strength of the required solution, written as a fraction (in 
terms of a hundred) multiplied by the strength of the stock solu- 
tion, also written as a fraction, (in terms of a hundred) but in- 
verted, multiplied by the number of cubic centimeters to be 
made up. 

The result is the number of cubic centimeters of the stock solu- 
tion to add to the required amount of water. 

All the known quantities however, must be reduced to 
their metric equivalents. 

Example: How much of a 5% solution of bichloride of 
mercury will have to be used to make up 1000 c.c. (one 
quart) of a 1-2500 solution. 

The required solution is 1 : 2500 

Written as a fraction it is 

2500 

5 
The stock solution is 5%: written as a fraction it is — and in- 
' ' 100 

*a -4. • 10 ° 
verted it is — 

5 



SOLUTIONS 39 

The number of cubic centimeters to be made up is 1000, then 



-£560- 5 25 

25 
The amount of the 5% solution of bichloride of mercury 
to be used, is therefore, 8 c.c. ; which, added to 1000 c.c. of 
water makes up a 1 to 2500 solution. 

Example : How much of a solution of silver nitrate, con- 
taining 48 grains to the ounce, must be used to make up 
one pint of a 1 to 1000 silver nitrate solution. 

A solution of silver nitrate, containing 48 grains to the 
ounce is the same as 48 grains to 480 grains; or -£fo = T 1 ir or 
a ten per cent solution, or T VV or T V. 

1 pint = 500 cubic centimeters 
The solution to be made up, is a 1 to 1000; written as a fraction 

... 1 

it is 

1000 

The stock solution is a 10% solution, or 1 to 10, written as a 

fraction it is — and inverted, it is — 
10 1 

then X — X 660- = the amount of stock solution to use 

1UUU 1 

2 

The amount to use, is therefore 5 cubic centimeters of 
the stock silver nitrate solution, which is added to 1 pint 
or 500 cubic centimeters. 

Example: How much of a 1 to 1000 potassium perman- 
ganate solution will have to be used in making up five pints 
of a 1-3000 solution. 

The required solution is 

3000 

The stock solution is , inverted = 

1000 1000 1 

5 pints = 2500 c.c. (since 1 pint = 500 cubic centimeters) 
then — x~^" X 2500 = X 

OVJUIT 1 

3 

X = = 833J cubic centimeters 



40 MATERIA MEDICA 

or approximately, 833 cubic centimeters of the 1-1000 potas- 
sium permanganate solution is added to 5 pints of water, to 
make up a solution of 1 to 3000. 

METHODS OF PREPARING DOSES OF DRUGS FROM 
TABLETS OR FROM SOLUTIONS OF VARIOUS 
STRENGTHS 

(1) Methods of Administering Tablets 

Hypodermic tablets are usually made in certain definite 
strengths, and various combinations of drugs. To a dminis ter 
them, they should be dissolved in about 1 c.c. (m. xv) of 
sterile water, which is then drawn up into the syringe, and 
administered to the patient. 

Occasionally, the nurse may not have a particular tablet 
of a certain dose with her, and she may be unable to obtain 
it at short notice. In such cases she should find out what 
part the required dose is of her stock tablets, and give that 
fraction of her stock tablet. This is best done by dissolving 
the stock tablet in about 1 or 2 c.c. of sterile water, and 
giving the necessary fraction of the amount. 

Example : How would you give a patient *V gr. strychnine 
sulphate when you have only tablets of ^ gr. 

To give ^V g r - from a ^V gr. tablet, we will give as much as 
*V is contained into -fa or 

1_ ± 1 30 = 30 = 1 
60 ' 30 ~ 60 X 1 ' 60 2 

We therefore have to give \ of the ^V gr. tablet. This 
is best done by dissolving the ^V gr. tablet in 1 c.c. (m. xv) 
of sterile water, and then giving about 0.5 c.c. (m. viii) of 
that solution to the patient. 

Rule 1. To find therefore, what part of a stock tablet should 
be used to give a required dose, divide the dose of the stock 
tablet into the required dose. The result is the amount or frac- 
tion of the stock tablet to use. 

Example: How would you give ^ gr» of atropine when 
you only have tablets of T fa gr. 



SOLUTIONS 41 

The required dose is — gr. The stock dose is — gr. 
120 100 

_L JL J- iop = ioo = 5 

120 ' 100 ~ 120 > 1 " 120 " 6 

5 1 

We therefore give - of the — gr. tablet 

6 100 

Therefore, dissolve the tablet in 2 c.c. or (m. xxx) of 
sterile water, fill up the hypodermic syringe with the resulting 
solution and give 1.5 c.c. or (m. xxv) of the contents of the 
syringe. 

In administering hypodermic drugs, the quantity of fluid 
injected, should never be less than 0.6 (six decigrammes) or 
10 minims; as smaller quantities are difficult to handle. 

To administer smaller doses of drugs when only a limited 
number of tablets of a greater strength are in stock. 

The nurse may be called upon to give smaller doses of 
drugs, than those she has with her, and she may be unable to 
obtain the necessary tablets at short notice. 

Example: The doctor orders a patient to have ^Jr gr. of 
strychnine every two hours. The nurse only has one tablet 
of ^V gr. with her. How many doses of ^ of a grain has 
she with her, and how should she prepare an accurate dose? 

She has as many doses as — is contained into — 

300 30 

10 

To administer the proper amount, she should dissolve 
the tablet in 10 cubic centimeters of water and give 1.0 
c.c. or 15 minims, for each administration, since every cubic 
centimeter contains ^ gr. 

Rule 2. To find the number of smaller doses of drugs that are 
contained in a limited number of stock tablets of a greater 
strength, divide the dose to be administered into the total amount, 
or total fraction, of the stock tablets. 

The result is the number of doses the nurse has in stock. 
Dissolve the stock amount in the resulting number of cubic 



1 1 


1 300 300 


or r — 


= . y := 


30 300 


30 1 30 



42 MATERIA MEDICA 

centimeters of water. Every cubic centimeter, or every 
15 minims will then contain the required dose. 

Example : To administer ^ gr. strychnine when the nurse 
has only two tablets of ^V gr. each in stock. 

1 _ — the amount in stock 

20 20 10 

The required dose is — gr. 
400 

1 ^ J_ = 400 = 4Q 
10 400 10 

The nurse then has 40 doses of strychnine, each containing 
T ^ gr. Dissolve the two tablets in 40 c.c. of sterile water, 
and give 1 c.c. (m. xv) for each dose. 



TO MEASURE A REQUIRED DOSE OF A DRUG FROM 
STOCK SOLUTIONS OF VARIOUS STRENGTHS 

In hospital practice, the nurse is often called upon to 
obtain for hypodermic or internal use a fractional dose of a 
drug, from solutions of various percentages. 

Often the correct amount can be obtained by measuring 
a definite quantity of the stock solution. 

For example: To give T fo gr. strychnine from a 1% 
solution. 

Each minim (or drop) contains y-j-g- grain of strychnine. 

To administer such a dose, it is only necessary to draw 
up a quantity of the solution in a minim dropper, drop one 
drop in a medicine glass, and add about 9 minims (or drops) 
of water. Draw the entire quantity (10 drops) into a 
hypodermic syringe, and administer it to the patient. 

Example: To give T V gr. strychnine from a 1% solution. 

Each drop of the 1% solution contains T fo- gr. of strych- 
nine. 

Since each drop contains — gr., — gr. will be contained in as 

100 25 

many drops as — is contained into — or 
100 25 

.I ^ JL = Jl ioo _ loo d 

25 " 100 25 1 " 25 

We therefore give 4 minims (or drops) of the 1% strych- 
nine solution, to administer T V g r - 

Rule 1. If the correct dose can be obtained from the stock 
solution, divide the fraction of a grain contained in one drop of 
the stock solution, into the required dose, and take the result- 
ing number of drops of the stock solution. 

To the number of drops thus obtained, add enough water 
to make up at least 10 or 15 minims, draw up the resulting 
solution into a hypodermic syringe and administer it to the 
patient. 

43 



44 MATERIA MEDICA 

Example: To give te gr. of strychnine from a solution of 
which m. x = ^V gr. 

Since m. x = — gr. each drop or 
30 

m. i, will contain — of — or — gr. 
10 30 300 

If each drop contains ^ gr., -gg gr. will be contained in as 
many drops as ^ is contained in -^ or 

1 1 1 300 300 ■ 

_i_ __ \/ _ _ io 

25 ' 300 25 1 " 25 



We therefore would have to give the patient 12 drops of the 
stock solution (of which m. i = ¥ V gr.). 

Example: To give 4 grs. of caffeine sodium benzoate from 
a 25% solution. 

Each drop of a 25% solution contains T V^gr. of caffeine 
sodium benzoate or \ gr. 

To give 4 grs. therefore, we would have to give as many 
drops as \ is contained into 4. 

1 4 

or4-i--=4x- = 16 
4 1 

We would give then, 16 drops of the 25% caffeine sodium 
benzoate solution — to administer a dose of 4 grains. 

The above method is only applicable, however, in cases 
where the correct amount can be obtained from the original 
stock solution. 

In most cases, the following method is better, especially 
where the accurate quantity cannot be measured easily. 

In such cases, the solution must be diluted, so that the 
nurse can then measure the required amount accurately. 

Example: To give -fa gr. of atropine from a 1% solution. 

By taking one part of the solution and two parts of water, 
a solution is obtained of which each drop contains ^fa gr. 

Practically, this is obtained by taking one drop of the 
stock solution, adding two drops of water to this, and taking 
one drop of the resulting solution, and then adding enough 
water to fill the hypodermic syringe. 



SOLUTIONS 45 

Note. The drop referred to, in the foregoing and following 
examples, refers to the drop obtained from a minim dropper. 

The following method will enable the nurse to find out in 
every case the number of times necessary to dilute the stock 
solution. 

1. The fraction of a grain of a drug contained in each 
drop of a solution is the proportion of the drug to water in 
that solution. 

For Example: Each drop of a 1% solution contains — S r - 

2 1 

Each drop of a 2% solution contains or — of a grain 

100 50 

4 1 

Each drop of a 4% solution contains or — of a grain 

100 25 

Rule 2. Reduce the smallest fraction of a grain contained in 
one drop of the stock solution, and the fraction to be adminis- 
tered, to fractions with the same least common denominator. 

To find the proper dilution, take one drop of the stock solution, 
add as many drops of water, as the difference between the nu- 
merator of the fraction contained in one drop of the stock solu- 
tion, and the numerator of its equivalent fraction. 

The number of drops of the resulting solution to use, is in- 
dicated by the numerator of the required dose, when reduced 
to its equivalent fraction. 

Example: To give ?fo of gr. atropine from a 1% solu- 
tion. 

1. Each drop of the atropine solution contains gr. 

100 

2. The required dose is gr. 

200 

3. The least common denominator of 100 and 200, is 200 

1 2 

100 ~ 200 

1 1 

200 ~ 200 

Then take one drop of the atropine solution, and add one 
drop of water, since 2-1=1. 



46 MATERIA MEDICA 

(This makes a solution of which each drop contains -fa gr.) 

The number of drops of the resulting solution to use, 
is indicated by the numerator of -jfo when reduced to its 
equivalent fraction, -^, which is 1. 

We therefore take one drop of the atropine solution, add 
one drop of water, and then take one drop of the resulting 
solution. To this drop, add enough water to fill about 10 
minims of the hypodermic syringe and administer this to the 
patient. 

Example: How would you give T ^ gr. of atropine from a 
1% solution? 

1. Each drop of the atropine solution contains — gr. 

100 

2. The required dose is gr. 

150 

3. The least common denominator of 100 and 150 is 300 

1 3 

100 ~ 300 

1 J2_ 

150 ~ 300 

Take one drop of atropine solution, add to that as many 
drops of water as the difference between the numerator of 
the stock fraction T fo- (numerator = 1), and its equivalent 
fraction ^ (numerator = 3) 3 — 1 = 2. 

Add therefore, 2 drops of water. 

The numerator of the required fraction when reduced to 
its equivalent fraction, T J-g- = ¥ | ¥ (numerator = 2), is the 
number of drops of the resulting fraction to use. 

To give T fo g r - atropine from al% solution, we take one drop 
of the stock solution add 2 drops of water, and take 2 drops 
of the resulting solution, then add about 8 drops of water, 
and administer the drug. 8 drops of water are added, since 
hypodermic medicines should never be given in quantities 
less than 0.6 c.c. (10 minims) in order to overcome leakage 
from the syringe. 

Example: To give ^ gr. atropine sulphate from a |% 

solution. Each drop of \ % atropine solution contains 

i 

100 " 2inr &% 



SOLUTIONS 47 

Least common denominator is 600 

200 600 

J_ JL 

300 600 

Then take one drop of the \% atropine solution and add 
two drops of water (3-1 = 2) and take two (numerator of 
trfo, which is same as ^) drops of the resulting solution. 

Rule 3. To measure doses greater than that contained in 
one drop of stock solution. 

In preparing doses less than that contained in one 
drop of the stock solution, we find no difficulty with this 
method. In doses greater than that contained in one drop 
of the stock preparation, we may find, that when we take one 
drop of the stock solution, and after adding the required 
number of drops of water, the total amount made up, may 
be less than the number of drops of the resulting solution 
to use. 

Example: To give -fa gr. of strychnine, from a 1% solu- 
tion. Each drop of a 1% solution contains T fo gr. strych- 
nine. 

J_ = A 
100 300 
J_ _5_ 

60 " 300 

3-1=2 the number of drops of water to add. 

We would then have to take one drop of the stock solution, 
and add to this, two drops of water. We then take five 
drops of this resulting solution; but, the total number of 
drops of the resulting solution, is only three, while the 
number to be used, is five, more than the total amount. 

Since the object of taking one drop of the stock solution, 
and adding two drops of water, is to make up a solution, of 
which each drop shall contain ?hf of a gr. of strychnine, 
and then, instead of giving ^ gr. of strychnine, we give, 
what is equal to it, -gfa of gr. or 5 drops of the resulting 
solution. 



48 MATERIA MEDICA 

Instead then, of taking one drop of the strychnine stock 
solution, and adding two drops of water, thus making up only 
three drops of a solution (of which each drop contains ?fo 
gr.), we multiply the number of drops of the stock solution 
to use, and the number of drops of water to add to this, each 
by 5, or 10, or any number greater than the number of drops 
to administer. In this way, we make up a larger quantity 
of the same solution, each drop of which contains yfa gr. 
In the example given above, if we multiply the number of 
drops of stock solution to use, and the number of drops of 
water to add to this, each by 5, we make up 15 drops of a 
solution, each drop of which contains ^ gr. of strychnine. 
Five drops of this solution will contain -fa or ^ gr. of 
strychnine. 

Therefore, whenever we find that the total of one drop of the 
stock solution, and the number of drops of water to be added, 
is less than the number of drops of this resulting solution to be 
given, we multiply both the drop of solution, and the number of 
drops of water to be added to it, by any number that will make 
the total number of drops to be made up, greater than the 
amount of drops to be administered. 

Example: To give T ^ gr. strychnine from a \% solu- 
tion. 

Each drop of the strychnine solution contains ?fa gr. 
strychnine. 

Least common denominator of 200 and 120 = 600 

1 _3_ 
200 600 

120 600 

Take one drop of \% solution of strychnine, add 
(3 - 1 = 2) 2 drops of water, and take 5 drops of the re- 
sulting solution; but the total amount of the resulting 
solution is only 3 drops, then we multiply the drop of stock 
solution, and the number of drops of water to add, each 
by 3. We would then take 3 drops of the \% solution of 



METHOD OF PREPARING AND ADMINISTERING REQUIRED 
DOSES OF MEDICINES FROM STOCK SOLUTIONS OF 
VARIOUS STRENGTHS 



^^-Jl 


&TI 


1, 


^ B ^^^^ p-| 












?.-.: ^ 


r~ak ' 


. 




IMP* 1 " ♦ H 


X 























Fig. 1. Apparatus necessary for measuring and administering solutions 
for hypodermic and internal use. 




Fig. 2. Measuring the required amount of stock solution. 




Fig. 3. Adding the necessary amount of water. 




Fig. 4. Measuring the required amount of the resulting solution. 



m A 


■F" 

■K 

■ 


T S^miBii^, , M ., , 




: " 



Fig. 5. Drawing up the required amount of the resulting solution into 
the hypodermic syringe. 




Fig. 6. The correct way to admin- Fig. 7. The wrong way to admin- 
ister hypodermic medication. ister hypodermic medication. 
(Note the direction of the needle.) 



SOLUTIONS 49 

strychnine, and add 6 drops of water to that, and then 
give the patient 5 drops of the resulting solution. 

Example: To give T V g r - of atropine from a solution of 
which m. v = A gr. 

1 .1.11 

Since m. v = — gr., m. i = - of — = — gr. 
40 5 40 200 

Each minim of the stock solution contains gr. atropine 

200 

The least common denominator of 200 and 75 = 600 

200 600 

75 600 

Take one drop of the atropine solution (stock) and add 
(3—1 = 2) drops of water, and take 8 drops of the resulting 
solution; but since the total amount of the resulting solution, 
is less than 8 drops, we multiply the number of drops of the 
stock solution, and the number of drops of water to add to 
this, each by 4 (to make up a sufficiently large quantity) . We 
then take 4 drops of the atropine solution, and add 8 drops 
of water, and then take 8 drops of the resulting solution. 

We therefore take 8 drops of the resulting solution, and 
draw it up into the hypodermic syringe and administer it to 
the patient. 



50 



MATERIA MEDICA 



TABLE OF USUAL STRENGTHS OF COMMONLY USED 
SOLUTIONS FOR EXTERNAL USE 



Name of Solution 



Alcohol 

Aluminium Acetate 
(Burrow's Solution) 
Stock sol 

Aluminium Acetate 
(Burrow's Solution) 
for local use 

Argyrol 

Boric Acid 

Calcium Hydroxide 
Solution (lime water) 

Carbolic Acid 

Collargol 

Cocaine Hydrochloride 

Chlorine water 

Corrosive Sublimate 
(Bichloride of Mer- 
cury) Stock Alco- 
holic Solution 

Corrosive Sublimate. . 
(Bichloride of Mer- 
cury) for use 

Creolin 

Cresol 

Eserine Sulphate 

Eserine Salicylate .... 

Formalin (Stock) Solu- 
tion 

Formalin (for use) — 

Holocain 

Hydrogen Peroxide. . . 

Icthyol 

Iron Subsulphate 

(MonselPs Solution) 
Iron Tersulphate 



Percentage of 


Solution 


50 


to 


95% 


2 


to 


7% 


V2 


to 


2% 


5 


to 


25% 
3% 

7»% 


2 


to 


5% 
4% 


V2 


to 


4% 
0.4% 

2% 


0.1 


to 0.01% 


(1-1000 to 1- 


-10000) 


H 


to 


2% 
5% 


y 2 


to 


1% 


V2 


to 


1% 

40% 


of formaldehyde 




gas 




v-l 


to 0.05% 


i 


to 


2% 
3% 


5 


to 


50% 

13% 
10% 



Number of Grains to 
Quart 



16 — 30 



oz. 



5 dr'ms — 2 oz. 



1 dr'm 
l^oz. 
1 oz. 

}/2 dr'm 
5 dr'ms 
1J4 dr'ms 
1% dr'ms 



5 dr'ms 
8 oz. 



13^ oz. 



5 dr'ms 

15 grs. — 2 grs. 



134 dr'm — 5 dr'ms 

l^oz. 

IK dr'ms— 2J^ dr'ms 

1% dr'ms— 2Y 2 dr'ms 



134 dr'ms — 10 grs. 

2J^ dr'ms 5 dr'ms 
1 oz. 

13^ oz. — 16 oz. 

4 oz. 
3 oz. 



SOLUTIONS 



51 



TABLE OF USUAL STRENGTHS OF COMMONLY USED 
SOLUTIONS FOR EXTERNAL USE 



Name of Solution 



Iodoform 

Labbaracque's Solu- 
tion (Solution of 
Chlorinated Soda). . 

Lugol's Iodine Solu- 
tion 

Lysol 

Naphthol 

Pilocarpine Hydro- 
chloride 

Potassium Chlorate 

Potassium Perman- 
ganate 

Protargol 

Resorcin 

Sodium Chloride (salt) 
(Normal Solution). . 

Sodium Chloride (salt) 
(Physiological Solu- 
tion) 

Silver Nitrate 

Zinc Chloride 

Zinc Sulphate 



Percentage of 
Solution 



5 to 10% 



M to 

2 to 



270 

5% 
M to 3 
1 to 50% 



Number of Grains to 
Quart 



5% 



1 to 5% 

y 2 to io% 



0.9% 



0.6% 
1 to 20% 

1 to 2% 



V/2 oz. — 3 oz. 



6 dr'ms 

1H oz. 

1 dr'm — 1 oz. 
2J^ dr'ms 16 oz. 

134 dr'ms — 5 dr'ms 
5 dr'ms 13^ oz. 

2^ dr'ms — IK oz. 
134 dr'ms — 3 oz. 
8 oz. 

2 dr'ms 



13^ dr'ms 

23^ dr'ms — 6 oz. 
2J^ dr'ms — 5 oz. 
35 grs. 



52 



MATERIA MEDICA 



TABLE OF USUAL STRENGTHS OF COMMONLY USED 
SOLUTIONS FOR INTERNAL USE 



Name of Solution 



Percentage of 
Solution 



Ammonium Bromide 

Ammonium Iodide 

Aromatic Spirits of Ammonia . 
Adrenalin Chloride 

Arsenious Acid Solution 

Caffeine Sodium Benzoate .... 

Camphor Oil 

Camphor Spirits 

Camphor Water 

Dilute Acetic Acid 

Dilute Hydrochloric Acid .... 

Dilute Hydrocyanic Acid 

Dilute Nitric Acid 

Dilute Nitrohydrochloric Acid 

Dilute Sulphuric Acid 

Diuretin Solution (Theobro 

mine Sodium Salicylate) . . . 
Fowler's Solution of Arsenic 

(Liquor Potassii Arsenitis) . . 
Homatropine Hydrobromide. . 

Mercury Salicylate 

Morphine Sulphate (Magendies 

Solution) 

Nitroglycerin solution 

Paregoric (Tinct. Opii. Cam- 

phorata) 

Potassium Iodide Solution (Sat 

urated) 

Potassium Iodide Solution. . . . 

Sodium Bromide 

Sodium Iodide Solution 

Spirits of Chloroform 

Spirits of Ether 

Spirits of Ether (Compound) . 
Strontium Bromide 



25% 
50% 

4% 
0.1% 
(1-1000) 

1% 

25% 
20% 
10% 

0.8% 

6% 
10% 

2% 
10% 
20% 
10% 

25% 

1% 
2% 
0.02% (1-5000) 



1% 



Number of grs. 
to Ounce 



0.4% 

100% 
50% 
50% 
50% 
10% 
30% 
30% 
50% 



2 dr'ms 

4 dr'ms 
20 grs. 

5 grs. 

2 dr'ms 

V/ 2 dr'ms 
50 grs. 

V/ 2 grs. 
30 m. 
50 m. 
10 m. 
50 m. 

l 2 / 3 dr'ms 

50 m. 

2 dr'ms 

5 grs. 

10 grs. 

7io gr. 

15 grs. 
5 grs. 

2 grs. 

480 grs. 

240 grs. 
4 dr'ms 

240 grs. 
50 m. 
2Y 2 dr'ms 
2Y 2 dr'ms 
4 dr'ms 



CHAPTER V 



CLASSIFICATION 



All drugs affect the body, or an organ of the body, by 
either increasing or lessening its activity. 

A drug which increases the activity of the body, or any of 
its organs, is called a stimulant: the act of increasing the 
activity is called stimulation. 

A substance which lessens the activity of the body, or 
any of its organs, is called a depressant: the act of lessening 
the activity is called depression. 

When the activity of an organ is increased to such an 
extent that it is overacting, it is said to be irritated or over- 
stimulated. A substance which produces such effects is 
called an irritant. 

The effects produced by irritation may be those of lessened 
activity or depression, since, by overacting, an organ may 
become exhausted. For example — the poisonous effects of 
some drugs which ordinarily increase the activity of the body, 
may be those of lessened activity. 

A poisonous substance usually harms the patient by either 
causing a very great overactivity of the body (irritation), 
or by greatly lessening its activity (depression). 

Most drugs increase or lessen the activity only of one 
or a number of organs of the body. 

We can classify all drugs, therefore, according to whether 
they stimulate, or depress the activity of body, or any of its 
organs, and according to the organs they principally affect. 



53 



54 



MATERIA MEDICA 



CLASSIFICATION OF DRUGS 

(Only the most important drugs are here given) 

STIMULANTS DEPRESSANTS 

Increasing activity Lessening activity 

DRUGS ACTING ON GASTERO-INTESTINAL TRACT 



Gentian 

Calumba 

Serpentaria 

Berberis 

Capsicum 

Cardamum 

Cinchona 

Ginger 

Peppermint 

Spearmint 

Wild Cherry 

Ipecac 

Apomorphine 



STOMACH 



INTESTINAL TRACT 



Phenolpthalein 

Cascara 

Castor Oil 

Senna 

Rhubarb 

Aloes 

Licorice 

Euonymus 

Scammony 

Elaterium 

Croton Oil 

Colocynth 

Gamboge 

Jalap 

Podophyllum 



CLASSIFICATION 55 



DRUGS ACTING PRINCIPALLY AFTER ABSORPTION 

DRUGS WHICH AFFECT THE BLOOD AND BLOOD 
FORMING ORGANS 

STIMULANTS DEPRESSANTS 

Iron 
Arsenic 
Calcium Lactate 

DRUGS WHICH AFFECT THE HEART 

Caffeine Aconite 

Atropine (Belladonna Group) Veratrum Viride 

Digitalis Group (Eserine) 

(Strophantus) (Pilocarpine) 

(Convallaria) 

(Squills) 

Strychnine 

Camphor 

Ammonia 

DRUGS WHICH AFFECT THE BLOOD VESSELS 

Adrenalin Amyl Nitrite 

Nitroglycerin 
(Nitrite Group) 

DRUGS WHICH AFFECT THE RESPIRATION 

(Atropine) Hydrocyanic Acid 

(Caffeine) (Opium and Morphine) 

(Strychnine) (Chloroform) 

(Camphor) (Choral) 

(Aconite) 

DRUGS WHICH AFFECT THE NERVOUS SYSTEM 

THE BRAIN 
Alcohol Bromides 

Coca Hyoscine 

(Atropine) 
(Caffeine) 



56 MATERIA MEDICA 

STIMULANTS DEPRESSANTS 

TO PRODUCE ANAESTHESIA 
Chloroform 
Ether 

Ethyl Chloride 
Nitrous Oxide 

TO RELIEVE PAIN 
(ANODYNES) 

Opium and Morphine 
Cannabis Indica 
Gelsemium 

TO RELIEVE PAIN (ALLAY NERVOUSNESS), AND RE^ 
DUCE TEMPERATURE 

ANTIPYRETIC GROUP 
Acetanilid 
Antipyrine 
Phenacetine 
Pyramidon 
and similar unofficial products 

TO PRODUCE SLEEP 
HYPNOTICS 
Chloral Group 

Trional 

Tetronal 

Veronal 

Sulphonal 

Chloretone 

Hypnal 

Paraldehyde 

SPINAL CORD 
Strychnine 

DRUGS ACTING ON THE SECRETORY GLANDS 

Pilocarpine (Atropine) 

(Eserine) Camphor 

(Ipecac) 



CLASSIFICATION 57 

DRUGS ACTING ON THE INVOLUNTARY MUSCLES 

STIMULANTS DEPRESSANTS 

Eserine Atropine 

DRUGS ACTING ON THE GENITAL ORGANS 

Ergot Viburnum 

Hydrastis (Hydrastinine) 

Rue 

Tansy 

Savine 

Pituitary Extracts 

(Quinine) 

DRUGS ACTING ON THE KIDNEYS 

Diuretin 

Agurin 

Potassium Acetate 

Potassium Citrate 

Potassium Bitatarate 

Potassium Nitrate 

Sodium Acetate 

Sodium Nitrate 

Caffeine 

Theobromine 

(Digitalis Group) 

Mercury (Calomel and Blue Pill) 

SPECIFICS 

DRUGS WHICH CURE PARTICULAR DISEASES (USUALLY 
BY DESTROYING THE CAUSE) 

FOR MALARIA 

(Arsenic) 
Quinine 

FOR SYPHILIS 
Mercury 
Salvarsan 
Iodides 



58 MATERIA MEDICA 



FOR RHEUMATISM 

Sodium Salicylate 

Salicylic Acid 

Salicin 

Salol 

Aspirin 

And Their Derivatives 

FOR GOUT 

Colchicum 



ANTHELMINTICS 
DRUGS WHICH DESTROY WORMS 

FOR TAPE WORM 

Aspidium 

Cusso 

Pepo 

Kamala 

Granatum 

Pelletierine 

FOR ROUND WORM 

Santonin 

Spigelia 

Senna 

FOR THREADWORM 

Quassia 
(Alum) 

FOR HOOK WORM 

Thymol 

Naphthol 

(Calomel) 



CLASSIFICATION 59 

DRUGS ACTING CHEMICALLY 

ACIDS 
MINERAL ACIDS 

Hydrochloric Acid 
Sulphuric Acid 
Nitric Acid 

VEGETABLE ACIDS 

Acetic Acid 
Citric Acid 
Tartaric Acid 

ALKALIES, ALKALINE EARTHS, AND THEIR SALTS 

Sodium 
Potassium 
Ammonium Salts 
Calcium 
Magnesium . 

ASTRINGENTS 

DRUGS WHICH CONTRACT TISSUES AND CHECK 
SECRETIONS OF MUCOUS MEMBRANES 

METALLIC 

Lead 

Copper 

Zinc 

Aluminium 

Silver 

Bismuth 



Salts 



VEGETABLE 

Tannic Acid 
Gallic Acid 
Tannigen 
Tannalbin and numerous other similar compounds 



60 MATERIA MEDICA 



ANTISEPTICS 



DRUGS WHICH CHECK THE GROWTH OF BACTERIA 

Carbolic Acid 
Creolin 
Lysol 

Sulphur Dioxide 
Calcium Chloride 
Bichloride of Mercury 
Potassium Permanganate 
Hydrogen Peroxide 
Boric Acid 
Formalin 
Iodoform 
Eucalyptus 
Icthyol 
Urotropin 
Salol 
Naphthol 
Thymol 
Copaiba 
Cubebs 
And numerous other similar compounds 



DRUGS WHICH ARE USED PRINCIPALLY TO PRODUCE 
LOCAL EFFECTS ON THE SKIN 

RUBEFACIENTS 

Drugs which cause redness of the skin 

Mustard 
Turpentine 
Arnica 
And many other similar substances 

VESICANTS 
Drugs which produce blisters 

Cantharides 
(Mustard) 



CLASSIFICATION 61 

PUSTULANTS 

Drugs which produce small blisters filled with pus 
Croton Oil 
Tartar Emetic 

CAUSTICS 

Drugs which are used to destroy tissues 
Mineral Acids 
Glacial Acetic Acid 
Caustic Potash 
Caustic Soda 
And strong solutions of the metallic astringents 

DEMULCENTS AND EMOLLIENTS 

Drugs which soften and protect the skin or mucous mem- 
branes 

Vaseline 
Cocoa Butter 
Olive Oil 
Lanoline 
Glycerin 
Starch 
Flaxseed 
Acacia 
And other mucilaginous substances 

SERUMS, ANTITOXINS, AND VACCINES 

Antistreptococcus Serum 
Antipneumococcus Serum 
Diphtheria Antitoxin 
Tetanus Antitoxin 
Tuberculin 

Staphylococcus Vaccine 
Streptococcus Vaccine 
Smallpox Vaccine 
Bulgaric Bacilli Preparations 
And many other similar preparations 



62 MATERIA MEDICA 



ORGANIC SUBSTANCES 



DRUGS OBTAINED FROM VARIOUS ORGANS OF 
ANIMALS 

Thyroid Extracts 
Pituitary Extracts 
Ovarian Extracts 
Adrenalin and many other similar substances 

Special names are given to drugs causing particular effects. 

The following is a list of the most important names given 
to various drugs: 

Absorbents are substances which increase the absorption 
of diseased tissue. 

Alteratives are drugs, whose mode of action is un- 
known, but which improve the nutrition of the tissues, and 
help to absorb diseased tissues, thereby restoring them to 
their normal condition. 

Anaesthetics are drugs which produce insensibility to 
pain. 

A Local Anaesthetic is one which produces insensibility to 
pain at the point of application. 

A General Anaesthetic is one which produces insen- 
sibility to pain all over the body. These drugs also pro- 
duce unconsciousness. 

Analeptics are substances which bring about health and 
strength. 

Analgesics are drugs which relieve pain. 

Anodynes are drugs which relieve pain. 

Antacids are drugs which neutralize acids. They are 
usually given to neutralize the acid in the stomach. 

Anthelimintics are drugs which destroy or expel worms. 

Antiarthritics are drugs which relieve gout. 

Antilithics are drugs which prevent the formation of 
stone^. 

Antiperiodics are drugs which relieve regular attacks of 
chills and fever, as in malaria. 

Antipyretics are drugs which reduce fever. 



CLASSIFICATION 63 

Antiseptics are substances which check the growth of 
germs. 

Antisialogogues are drugs which check the flow of saliva. 

Antispasmodics are drugs which lessen contractions of 
muscles, and also lessen convulsions. The term is also 
applied to drugs which lessen nervousness, because of the 
tremors of the muscles which often occur in these condi- 
tions. 

Antizymotics are drugs which check the action of germs. 

Aperients are substances which produce mild movements 
of the bowels. 

Aromatics are spicy substances which increase the secre- 
tion of the stomach and intestines. 

Astringents are drugs which contract or harden tissues. 

Bitters are drugs which increase the appetite because of 
their bitter taste. They also increase the flow of gastric 
juice. 

Cardiac Stimulants are drugs which increase the activity 
of the heart, so that it beats stronger and faster. 

Cardiac Depressants are drugs which lessen the heart action 
so that the heart beats slower and weaker. 

Carminatives are drugs which produce a feeling of com- 
fort in the stomach and relieve the formation of gas in 
the stomach and the intestines. They also increase the 
appetite. 

Cathartics are drugs which cause movements of the 
bowels. 

Caustics are substances which burn or destroy the tissues. 

Cholagogues are drugs which cause movements of the 
bowels, the stools being colored with bile. They are said to 
increase the flow of bile. 

Cerebral Stimulants are drugs which increase brain activity 
making the patient more active, brighter and more talka- 
tive (in large doses such drugs may produce delirium, 
hallucinations, convulsions, etc.). 

Cerebral Depressants are drugs which lessen brain ac- 
tivity. The patient is dull and less active. In large doses 
they may produce sleep. 

Convulsants are drugs which produce convulsions. 



64 MATERIA MEDICA 

Correctives are substances used to make unpleasant drugs 
more pleasant to the taste. 

Counter Irritants are drugs which relieve pain or affect 
an organ or part of the body, by being applied to an area of 
the skin which has nerves communicating with that organ 
or part of the body. 

Delirifacients are drugs which increase the activity of the 
brain, and often cause delirium. 

Demulcents are bland slippery liquids, used to coat, protect 
and lubricate a mucous membrane or surface of the body. 

Deodorants are remedies which destroy unpleasant odors. 

Depilatories are substances used to remove hair. 

Depresso-motors are drugs which lessen the impulses for 
motion sent from the brain or spinal cord. 

Depurants are drugs which increase the excretions of the 
body and thereby purify it. 

Detergents are substances which clean wounds. 

Diaphoretics are drugs which cause perspiration. 

Digestives or Digestants are substances which aid the 
digestion of food. 

Disinfectants are drugs which check the growth of bacteria. 

Diuretics are drugs which increase the flow of urine, both 
in amount and frequency. 

Ecbolics are drugs which contract the uterus and empty 
its contents; thereby producing abortion, or assisting labor. 

Emetics are drugs which produce vomiting. 

Emmenagogues are drugs which bring about menstrua- 
tion. 

Emollients are drugs which soften and protect the sur- 
face of the body. 

Errhines are drugs which increase the nasal secretions, 
and produce sneezing. 

Epispastics or Escharotics are drugs which produce blisters 
and destroy the skin of the area over which they are ap- 
plied. 

Excito-motors are drugs which increase the impulses for 
motion, that are sent out from the brain or spinal cord. 

Expectorants are drugs which increase coughing and 
bronchial secretions. 



CLASSIFICATION 65 

Evacuants are drugs which empty the bowels 

Febrifuges are drugs which reduce fever. 

Galactogogues are drugs which increase the secretion of 
milk. 

Haemostatics are substances which check bleeding. 

Hydragogues are drugs which produce frequent watery 
movements of the bowels. 

Hypnotics are drugs which produce sleep. 

Laxatives are drugs which produce few mild movements 
of the bowels. 

Myotics are drugs which narrow (contract) the pupil of 
the eye. 

Mydriatics are drugs which (widen) dilate the pupil of 
the eye. 

Oxytocics are drugs which increase contractions of the 
uterus. 

Prophylactics are medicines which prevent the develop- 
ment of a disease. 

Purgatives are drugs which produce moderately active 
and frequent movements of the bowels. 

Refrigerants are substances which relieve thirst and cool 
the patient, in fever. 

Respiratory Stimulants are drugs which increase the depth 
and frequency of breathing. 

Respiratory Depressants are drugs which lessen the fre- 
quency and depth of breathing. 

Revulsants are drugs which draw blood from the deeper 
parts to the surface. 

Rubefacients are drugs which redden the skin by widening 
(dilating) the capillaries. 

Saline Purgatives are mineral salts which produce move- 
ments of the bowels. 

Somnifacients or Soporifics are drugs which produce sleep. 

Sedatives are drugs which lessen the activity of an organ 
or part of the body. 

Sialogogues are substances which increase the flow of 
saliva. 

Specifics are drugs which cure particular diseases ; usually 
by destroying or combining with, the causative agent. 



66 MATERIA MEDICA 

Stomachics are drugs which increase the activity of the 
stomach and intestines. They increase the appetite and aid 
digestion. 

Styptics are substances which stop bleeding. 

Sudorifics are drugs which produce sweating. 

Taenicides are drugs which destroy tape worms. 

Tonics are drugs which brace up the patient. They 
improve the health and vigor of every part of the body. 
They make the patient feel stronger, healthier, more ener- 
getic, and increase the appetite. 

Vermicides are drugs which destroy worms. 

Vermifuges are drugs which expel worms. 

Vesicatories and Vesicants are drugs which produce blisters. 



ABSORPTION, MODE OF ACTION AND CUMULATIVE 

ACTION 

Drugs which act on different organs of the body, enter 
the blood stream by being directly injected into it (intraven- 
ous administration), or by being absorbed from the tissues 
into which they are injected (hypodermic administration), 
or by passing through the lining membrane of the stomach 
or intestines and entering the blood in this manner (internal 
administration) . 

By the circulation of the blood, a drug is carried to the 
different organs of the body and there it produces its effects. 

The effects on the body or on any of its organs are produced : 

1. By combining chemically with some of the cells of the 
various organs, and thereby modifying their activity. Drugs 
like morphine, or strychnine, act in this way. 

2. By dissolving some of the substances of the cells, and 
changing their activity in this manner. Ether and chloro- 
form act in this way. 



EXCRETION 

After the effects are produced, the body gets rid of the 
drug through the various excretory organs such as the skin, 
the lungs, the kidneys and the bowels. 



CLASSIFICATION 67 

A drug may be excreted either in its original form, or 
as some other modified substances. 



CUMULATIVE ACTION 

Some drugs are excreted much slower than they are 
absorbed. If such a drug is administered for any length of 
time, a part of each dose always remains in the body. The 
effects produced by the amount of drug which accumulates 
in the body, are called cumulative effects. A drug which 
produces such effects is said to have a cumulative action. 

As a result of this action, a patient may often get poison- 
ous symptoms when some drugs are given continuously. 
For, while the patient may be getting an average dose of 
the drug at every administration, a portion of the previous 
dose always remains in the body, and the effects pro- 
duced, are not due entirely to the dose administered, but 
to it, and the part remaining in the body from the previous 
dose. They are therefore greater than is to be expected, 
from one dose. 

Drugs which cause cumulative effects are best given for 
a definite period of time, after which they should be stopped 
for a while, to allow all of the drug remaining in the body to 
be excreted, and then they may be given again. 

For example, in administering digitalis, which has a 
cumulative action, it is better to give it for a definite length 
of time, and then stop the drug for a while, to allow the body 
to get rid of most of it; thereby avoiding poisonous effects 
from its cumulative action. 



PART I— GASTRO-INTESTINAL STIMULANTS 

Drugs which Increase the Activity of the Gastro- 
intestinal Tract 

CHAPTER VI 

GASTRIC STIMULANTS 

The stomach changes certain kinds of food (proteids), 
such as eggs, meat, etc. to simpler, more fluid substances, 
so that they can be more readily absorbed through the lining 
membrane of the stomach and intestines, and that they may 
be more easily acted upon by the digestive juices of the 
intestinal tract. This process is called digestion. 

The digestion of the food is brought about by means of 
the gastric juice which is secreted by the lining membrane 
of the stomach. This juice contains two ferments; pepsin 
and rennin, which together with hydrochloric acid, which 
is also secreted in the stomach, changes the complex food 
substances into simpler, more fluid ones. 

While these changes are going on, the contractions of 
the involuntary muscles (peristalsis) of the stomach wall, 
move the food onward into the intestines, so that the stomach 
is completely emptied in about two hours. 

The functions of the stomach then, are: 

1. Secretory, to secrete gastric juice and digest the food. 

2. Motor, to move the digested food onward, into the 
intestines for further digestion. 

A drug may increase only one or both of these functions 
of the stomach. 

BITTERS 

Bitters are vegetable drugs which increase the activity of 
the secretory function of the stomach, but produce no effects 
after absorption. 

69 



70 MATERIA MEDICA 

There are two kinds of bitters. 

1. Simple bitters: These are vegetable substances which 
increase the activity of the stomach, and increase the ap- 
petite. 

2. Aromatic bitters are vegetable substances having a 
pleasant odor, because of oils that evaporate easily (vola- 
tile oils), which these drugs contain. They also increase 
the activity of the stomach. 

There are other drugs, which cause important effects 
after absorption, but may also act as bitters in the stomach, 
for example, nux vomica and quinine. 

Many substances used as condiments in food, produce 
the same effect. 

Action 

Simple bitters have no local action on the skin. 

When taken internally, they increase the appetite, and the 
secretion of gastric juice. 

The patient therefore eats more, and digests his food 
better. 

If they are taken for a long period of time, he gains in 
weight, feels better, and is generally more robust, healthier 
and stronger. 

Poisonous Effects 

Occasionally, some of the bitters, such as quassia and 
berberis, if given in large quantities, may cause diarrhoea, 
frequent urination, nausea, vomiting, restlessness, and a rapid 
weak pulse. These symptoms are due to the alkaloids 
quassin and berberine which they contain. 

Administration 
Bitters should always be given before meals in fluid form. 

SIMPLE BITTERS AND THEIR PREPARATIONS 

GENTIAN: The root of the Gentiana lutea, or the yellow 
gentian of the Alps. Dose 1.0 gm. (mxv) 

Extract of Gentian 0.1- 0.6 gm. grs. ii-x 

(Extractum Gentianae) 



GASTRIC STIMULANTS 71 

Fluidextract of Gentian 0.6- 2.0 c.c. m. x-xxx 

(Fluidextractum Gentianae) 

Compound Tincture of Gentian 2.0-16.0 c.c. 5i~iv 

(Tinctura Gentianae Composita) 

Gentian is often used as a mild laxative. 

CALUMBA: The root of Jateorrhiza palmata, a climbing 
vine which grows in Mozambique. 

Fluidextract of Calumba 1.0- 2.0 c.c. m. xv-xxx 

(Fluidextractum Calumbae) 

Tincture of Calumba 4.0-15.0 c.c. 3i-iv 

(Tinctura Calumbae) 

Calumba is often used in the treatment of thread worms. 

CHIRATA: The herb and root of Swertia chirata, a plant 
growing in the northern part of India. 

Fluidextract of Chirata 0.3-1.0 c.c. m. v.-xv 

(Fluidextractum Chiratae) 

BERBERIS: Barberry, a drug obtained from the root and 
berries of Berberis vulgaris, which grows in Europe. It con- 
tains an active principle, berberine, an alkaloid, and some 
tannin, which makes it slightly contract mucous membranes. 

Fluidextract of Berberis 2.0 c.c. m. xxx 

(Fluidextractum Berberidis) 

QUASSIA: A drug obtained from the wood of Picraena 
excelsa, a large tree which grows in Jamaica. It contains 
an active principle quassin. 

Extract of Quassia 
(Extractum Quassiae) 

Fluidextract of Quassia 
(Fluidextractum Quassiae) 

Tincture of Quassia 
(Tinctura Quassiae) 

Quassin (not official) 

A 10% infusion of quassia is given as an enema for round 
worms in children. 



0.06 -0.2 gm. 


grs. i-iii 


0.3 -2.0 c.c. 


m. v-xxx 


1.0 -4.0 c.c. 


m. xv-5i 


0.015-0.03 gm. 


grs. i-i 



72 MATERIA MEDICA 

CONDUR ANGO : The bark of the condurango tree. 

PAREIRA: The root of the Chondodendron tomentosum, 
a climbing plant of South America. These are other less 
important simple bitters. 

NUX VOMICA, CINCHONA, and their alkaloids, strych- 
nine and quinine are also used as simple bitters, but their 
general effects are more important; under which they will be 
considered. 

CETRARIN 0.06-0.2 gm. grs. i-iii 

This is a bitter principle obtained from Iceland moss. It 
is said to increase peristalsis, and the secretion of saliva, 
bile and pancreatic juice. 

OREXIN: This is an artificial chemical substance used as 
a bitter. It must not be given on an empty stomach, as it 
is somewhat injurious to the stomach. 



AROMATIC BITTERS 

The aromatic bitters increase the secretion of the lining 
membrane of the stomach more than the simple bitters do, 
on account of the volatile oils which they contain. Their 
effect is also more lasting, and they contract the mucous 
membranes, because of small quantities of tannic acid which 
many of them contain. 

They should always be given before meals, best in fluid 
form. 

Aromatic Bitters and Their Preparations 

SERPENT ARIA: The root of the Virginia snake root, a 
small herb, which grows in the United States. This is often 
combined with other bitters. 

Fluidextract of Serpentaria 1.0-2.0 c.c. m. xv-xxx 

(Fluidextractum Serpentariae) 

Tincture of Serpentaria 2.0-8.0 c.c. 5§-ii 

(Tinctura Serpentariae) 

PRUNUS VIRGINIANA: A drug obtained from the bark of 
the wild cherry tree. 

Its active principles are amygdalin, a glucoside, and an 
albuminous principle emulsin. Both these two substances 
if rubbed together form prussic acid (hydrocyanic acid). 

Prunus Virginiana is often given to increase expectora- 
tion and lessen coughing, together with other cough medi- 
cines. 

Fluidextract of Prunus Virginiana 2.0- 4.0 c.c. 3ss-i 
(Fluidextractum Pruni Virginianae) 

Infusion of Prunus Virginiana 15.0-60.0 c.c. 5ss-ii 
(Infusum Pruni Virginianae) 4% strength 

Syrup of Prunus Virginiana 4.0-15.0 c.c. 5i-iv 

(Syrupus Pruni Virginianae) 15% strength 

HUMULUS: Hops, and lupulin, a powder separated from 
hops. 

73 



74 MATERIA MEDICA 

Hops are often used in the form of poultices, to relieve 
pain and produce redness of the skin. The hops are placed 
in a bag and wrung out in hot water and the bag is then used 
as a local application, or it may be used dry. 

Lupulin (powder) 0.3-1.2 gm. grs. v-xx 

(Lupulinum) 

Fluidextract of Lupulin 2.0-8. c.c. 5i~ii 

(Fluidextractum Lupulini) 

Oleoresin of Lupulin 0.1-0.3 c.c. m. ii-v 

(Oleoresinae Lupulini) 

These preparations are often used in neurasthenia, to 
lessen nervousness. 

ANTHEMIS, CHAMOMILE: The dried flowers of Anthemis 
nobilis, a European plant. 

MATRICARIA, German chamomile: The flowers of Matri- 
caria, chamomilla, German plant. 

EUPATORIUM: The leaves and flowering tops of boneset, 
or thoroughwort. 

EUCALYPTUS: The leaves of the blue gum tree of Aus- 
tralia. 



CARMINATIVES 

The following drugs are used principally to check the 
formation, and aid in the expulsion of gas from the stomach 
and intestines. A drug which has such an action is called a 
carminative. These drugs contain volatile oils, and most 
of them act also as aromatic bitters. 

They are also used to check the griping pains, often caused 
by cathartics, and because of the pleasant odorous oils 
which many of them contain, they are used to disguise the 
taste of unpleasant tasting drugs. Some of them are used 
as condiments with food. 

Action 

Local Action: Applied to the skin, they act as antiseptics; 
and in strong solutions, they cause redness, pain and swelling, 
often blisters. 

On mucous membranes, they cause redness and swelling, 
pain and smarting, with excessive secretions of mucus. 

Internal Action 

In the mouth, they produce a hot burning taste, and in 
large doses they cause redness of the lining membrane of 
the mouth, and an increased flow of saliva, which aids in 
the digestion of the food. At the same time they have a 
very pleasant aroma, and their antiseptic action is again 
manifested. 

In the stomach, they cause a feeling of warmth, and a 
sense of comfort, and they relieve the feeling of distention 
after meals. 

By their antiseptic action, they lessen the formation, and 
by causing redness and swelling of the lining membrane of 
the stomach (irritating), they cause the muscle wall of the 
stomach to contract, and thus aid in the expulsion of gas 
(carminative action). 

Many of these drugs increase the appetite, and probably 
by their pleasant aroma, as well as by directly activating 

75 



76 MATERIA MEDICA 

the lining membrane of the stomach and intestines, they 
increase the secretion of the digestive juices, and aid in 
the digestion of food. 

In the intestines, by their antiseptic action, they lessen 
the formation of gas, and by causing redness and swelling 
(irritation), of the lining membrane, they bring about con- 
tractions of the muscle wall of the stomach and intestines, 
and help to expel gas. 

Action after Absorption 

Occasionally, some of these drugs may cause effects after 
absorption (see preparations below). 

Excretion 

These aromatic vegetable drugs are mostly excreted by 
the expired air and the urine, part of the drug being used up 
in the body, however. 

In their passage through the lungs, they increase the flow 
of bronchial secretion, thereby increasing expectoration, 
and in their passage through the kidneys, they may increase 
the flow of urine (diuretic action). 

Some of these drugs are given to produce these effects. 

CARMINATIVES (VOLATILE OILS) AND THEIR 
PREPARATIONS 

CAPSICUM, Cayenne Pepper: The extremely pungent fruit 
of the Capsicum fastigiatum, or African pepper. 



Tincture of Capsicum 
(Tinctura Capsici) 


2.0 -4.0 c.c. 


m. xxx-5i 


Fluidextract of Capsicum 
(Fluidextractum Capsici) 


0.03-0.06 c.c. 


m. | -i 


Oleoresin of Capsicum 
(Oleoresinae Capsici) 


0.01-0.05 c.c. 


m. i -i 


Capsicum Plaster 
(Emplastrum Capsici) 


For local use 




Capsicum causes marked redness and 


blistering of the 



GASTRIC STIMULANTS 77 

skin, often destruction of the area of skin over which it is 
applied. 

Internal Action 

In large doses it often causes violent pain in the abdo- 
men, with vomiting, followed by profuse diarrhoea and very 
painful urination. 

Uses 

Capsicum is used to increase the secretion of the stomach, 
particularly in drunkards, whose lining membrane of the 
stomach is so affected that it secretes very little gastric juice. 

It is also used in the form of a plaster to produce blisters, 
in order to draw fluid from deeper tissues into the skin. 

ZINGIBER, Ginger : The dried roots of the Zingiber officinale, 
which grows in the East and West Indies. Green ginger 
is the fresh, and black ginger, the dried roots. The fresher 
it is, the more active is the ginger. 

Fluidextract of Ginger 0.3-1.0 c.c. m. v-xv 

(Fluidextractum Zingiberis) 

Tincture of Ginger 2.0-4.0 c.c. 5 ss-i 

(Tinctura Zingiberis) 

Oleoresin of Ginger 0.06-0.2 c.c. m. i-ii 

(Oleoresinae Zingiberis) 

Syrup of Ginger 4.0-8.0 c.c. 3i-ii 

(Syrupus Zingiberis) 

CARDAMOMUM, Cardamom, is a drug obtained from the 
fruit of the Elettaria repens, which grows in the East Indies. 

Tincture of Cardamomum 4.0 c.c. 5i 

(Tinctura Cardamomi) 2% 

Compound Tincture of Cardamom 4.0-8.0 c.c. Si— ii 

(Tinctura Cardamomi Composita) 

The following aromatic drugs are used mainly as vehicles 
or excipients for other drugs, and as flavoring substances. 

AMYGDALA AMARA (Bitter Almonds). This is occasion- 
ally used as a carminative. 

The preparations usually given are: 



78 MATERIA MEDICA 

Bitter Almond Spirits 1.0-4.0 c.c. m. xv-5i 

(Spiritus Amygdalae Amarae) 

Syrup of Bitter Almonds 2.0-4.0 c.c. 53^-i 

(Syrupus Amygdalae Amarae) 

Bitter almonds contain a glucoside amygdalin which, 
when acted upon by a ferment emulsin, which it contains, 
hydrocyanic or prussic acid, is formed. This never occurs in 
the ordinary preparations, but when any of the preparations 
of bitter almonds are rubbed together with other prepara- 
tions prussic acid may be formed. Cases of hydrocyanic acid 
poisoning have occurred from mixtures which were prepared 
in this way. 

MENTHA PIPERITA (Peppermint Leaves) 

Oil of Peppermint 0.06-0.3 c.c. m. i-v 

(Oleum Menthae Piperitae) 

Spirits of Peppermint 4.0-8.0 c.c. 5i-ii 

(Spiritus Menthae Piperitae) 

Peppermint Water 
(Aqua Menthae Piperitae) 

MENTHA VIRIDIS (Spearmint Leaves) 

Oil of Spearmint 0.06-0.3 c.c. m. i-v 

(Oleum Menthae Viridis) 

Spirits of Spearmint 4.0 -8.0 c.c. 5i-ii 

(Spiritus Menthae Viridis) 

Spearmint Water 
(Aqua Mentha Viridis) 

CINNAMOMI CORTEX (Cinnamon Bark) 

Oil of Cinnamon 0.06-0.3 c.c. m. i-v 

(Oleum Cinnamomi) 

Cinnamon Spirits 4.0 -8.0 c.c. 5i-ii 

(Spiritus Cinnamomi) 

Cinnamon Water 
(Aqua Cinnamomi) 



GASTRIC STIMULANTS 79 

FLAVORING SUBSTANCES 

The following drugs act like the carminatives, because of 
volatile oils which they contain. They are used principally 

as flavoring agents. 

AURANTII DULCIS CORTEX (Sweet Orange Peel) 

AURANTII AMARI CORTEX (Bitter Orange Peel) 

Oil of Orange Peel 0.06-0.3 c.c. m. i-v 

(Oleum Aurantii Cortex) 

Fluidextract of Bitter Orange Peel 1.0 -2.0 c.c. m. xv-xxx 
(Fluidextractum Aurantii Amari) 

Compound Spirits of Orange Peel 4.0 -8.0 c.c. 5i-ii 

(Spiritus Aurantii Amari) 

(Containing the oil of Orange Peel, Lemon, Coriander and Anise) 

Tincture of Sweet Orange Peel 4.0 -8.0 c.c. Si— ii 

(Tincture Aurantii Dulcis) 

Tincture of Bitter Orange Peel 4.0-8.0 c.c. Si— ii 

(Tincture Aurantii Amari) 

ROSA GALLICAE PETALAE (Red Rose Petals) 

Oil of Rose gtts. i-ii 

(Oleum Rosae) 

Rose Water 
(Aqua Rosae) 

Strong Rose Water 

(Aqua Rosae fortior) twice as strong 

Unguentum Aqua Rosae 
(Cold Cream) 

ROSEMARY, a drug obtained from the fresh flowering tops 
of Rosemarinus officinalis. 

Oil of Rosemary gtts. i-ii 

(Oleum Rosemarini) 

Spirits of Rosemary 4.0-8.0 c.c. 3 i-ii 

(Spiritus Rosemarini) 

It is used principally as a local application for the skin. 



80 MATERIA MEDICA 

CARYOPHYLUS, Cloves. The oil of cloves, oleum caryoph- 
ilis is the preparation commonly used. It is applied on a 
piece of cotton for toothache, the cotton being placed in the 
cavity of the tooth. 

ANISE, the fruit of the Pimpinella anisum, a European 
plant. 

Oil of Anise 0.3-1.0 c.c. m. v-xv 

(Oleum Anise) 

Spirits of Anise 4.0-8.0 c.c. Si— ii 

(Spiritus Anisi) 

Anise is an ingredient of the Liquor ammonii anisatus 
of the German pharmacopoeia. It is a very commonly 
used expectorant among German physicians. 

LAVANDULA (Lavender Flowers) 

Oil of Lavender Flowers 0.3-1.0 c.c. m. v-xv 

(Oleum Lavandulae Foliorum) 

Spirits of Lavender 4.0-8.0 c.c. 5i-ii 

(Spiritus Lavandulae) 

Compound Tincture of Lavender 4.0-8.0 c.c. 5i-ii 

(Tincture Lavandulae Composita) 

(Lavender, Rosemary, Cinnamon, Nutmeg) 

Oil of cajuput is the volatile oil obtained by distilling 
the leaves of the Melaleuca leucadendron, a tree which grows 
in the Molucca Islands. 

Oil of Cajuput 0.3-1.0 c.c. m. v-xv 

(Oleum Cajuputi) 

The oil of cajuput has been used in the treatment of para- 
sitic skin diseases, and of round worms. 

GAULTHERIA (Wintergreen) 

Gaultheria is used principally in the treatment of rheu- 
matism, on account of the methyl salicylate which it con- 
tains, and its actions will be considered with these drugs. 

The following preparations are used as carminatives: 



GASTRIC STIMULANTS 81 

Oil of Wintergreen 0.3-1.0 c.c. m. v-xv 

(Oleum Gaultheriae) 

Spirits of Wintergreen 0.6-2.0 c.c. m. x-xxx 

(Spiritus Gaultheriae) 5% of the oil 



JUNIPER (Juniper Berries) 

Oil of Juniper 0.3-1.0 c.c. m. v-xv 

(Oleum Juniperi) 

Spirits of Juniper 4.0-8.0 c.c. Si— ii 

(Spiritus Juniperi) 

Compound Spirits of Juniper 4.0-8.0 c.c. 3i-ii 

(Spiritus Juniperi Compositus) 

Contains oil of juniper, caraway, and fennel 
Juniper has been frequently used to increase the flow of urine 
(diuretic) 

Other less important drugs used as flavoring substances 
are: 

MARRUBITJM, Horehound, the leaves and tops of the 
plant being used. It is used extensively as an expectorant. 

LIMONIS CORTEX, Lemon Peel. 
SASSAFRAS, Sassafras Bark. 
FOENICULUM, Fennel. 
PIMENTA, Allspice. 
CARUM, Caraway Seeds. 
MYRISTICA, Nutmeg. 

VANILLA, the unripe fruit of the Vanilla planifolia. Of 

these substances the oil, the spirit, and waters are official. 
Of vanilla the tincture is the most common official 
preparation used. 

COMPOUNDS OF VARIOUS VOLATILE OILS 

Aromatic Powder 0.3-2.0 gms. grs. v-xxx 

(Pulvis Aromaticus) 

(Contains cinnamon, cardamom, nutmeg and ginger in powder 
form) 



82 MATERIA MEDICA 

Fluidextract of Aromatic Powder 0.5-2.0 c.c. m. viii-xxx 
(Fluidextractum Aromaticus) 

Aromatic Elixir 

Elixir Aromaticum and Elixir Adjuvans are preparations of the 
compound spirits of orange peel used as flavoring agents. 

Other preparations used as carminatives are the Chloro- 
form water, Hoffman's anodyne (Compound spirits of ether), 
and a number of alcoholic preparations, such as curacoa, 
Cherrywater (kirschwasser) kummel, whiskey, rum, gin, etc. 



DIGESTANTS 

In cases where the stomach is so affected, that it secretes 
very little gastric juice, the patient is unable to digest his 
food. 

In such cases the digestion of the food can be assisted 
by giving various ferments which digest the various food 
substances, such as proteids, carbohydrates and fats, and 
which take the place of the gastric or intestinal juices which 
may be very much diminished or absent. 

Substances Used for Digestion of Carbohydrates 

Carbohydrates are starchy foods, such as bread, potatoes, 
and sugars. 

The starchy foods are partially digested in the mouth. 
They are changed to sugars by the saliva, which contains a 
ferment ptyalin. The digestion of the starchy foods and 
sugars is completed in the intestines, by the pancreatic 
juice, which contains the starch digesting ferment amylopsin. 

Malt 

Malt is barley grain which has begun to grow arti- 
ficially. The growth is then stopped by means of heat. 

During this growth the starch contained in the barley, 
is changed to sugar by means of a ferment which is con- 
tained in the barley grain. This ferment is called diastase. 

Malt which contains this ferment diastase, is often given 
to help the digestion of starches. Many of the preparations 
used, contain no diastase, and produce no digestive effects; 
though they are easily digested foods. Many of the malt 
extracts contain alcohol, and are therefore similar to beer 
or stout. 

Preparations 

Extract of Malt 16.0 gms. 3iv 

(Extractum Malti) 

A syrupy extract of malt. 



84 MATERIA MEDICA 

Unofficial Preparations 

Maltine 

Maltzyme and others 

Taka Diastase 

A starch digesting ferment produced by the action of a 
mould (Eurotium oryzae) upon wheat bran. It is named 
after its discoverer, Takamine, a Japanese. 

Taka diastase is very powerful and efficient, and also 
acts in the stomach before the normal amount of acid is 
produced. 

The action of starch digesting ferments are usually de- 
stroyed by the acid in the stomach. 

Substances Used for the Digestion of Proteids 

Proteids are food substances such as meat and eggs. 
Milk also contains a large proportion of proteids. 

The proteids are partially digested by the gastric juice; 
which consists mainly of pepsin and hydrochloric acid. 
Pepsin can only act in the presence of an acid. 

The proteids are completely digested by the pancreatic 
juice; which contains trypsin, a ferment which digests pro- 
teids completely; amylopsin, a ferment which digests starches 
completely, and steapsin, a ferment which breaks up the 
fats into very small globules (emulsifies). 

Pancreatic juice can only act in the presence of an alkali, 
and is destroyed by an acid, such as the acid in the stomach. 

PEPSIN 

Pepsin is a ferment obtained from the lining membrane 
of fresh stomachs of healthy pigs. It is used to aid digestion 
in cases where there is a diminished amount of gastric juice 
in the stomach. 

It only acts with an acid; and should always be given 
with dilute hydrochloric acid. Alkalies destroy its activ- 
ity, and it should therefore never be given with such sub- 
stances as sodium bicarbonate. 



GASTRIC STIMULANTS 85 

Preparations 

Pepsin 0.3-0.6 gm. grs. v-x 

(Pepsinum) 

The following unofficial preparations are often used: 
Essence of Pepsin 8.0 c.c. 3ii 

(Essentia Pepsini) 

Glycerite of Pepsin 3.0 c.c. m. xlv 

(Glyceritum Pepsinae) 
And the elixir of pepsin and pepsin solution. 

New and Non-official Preparations 
Elixir of Enzymes 4.0-8.0 3i-ii 

This is a solution containing pepsin and rennet in 20% of 
alcohol. 

Rennet 

Rennet is a ferment secreted by the mucous membrane 
of the stomach. It curdles milk. 

New and Non-official Preparations 

Pegnin 

Milk Sugar Rennet 

About 8.0-10.0 gms. (5ii— iiss) of pegnin are added to 
1000 c. c. of cool boiled milk. The mixture is then allowed 
to stand for two or three minutes, and is shaken until the 
clot which had been formed is uniform in consistency. This 
forms a finely divided clot and makes the milk easier to 
digest. 

PANCREATIN 

Pancreatin is a mixture of all the ferments obtained from 
the fresh pancreatic glands of the pig. It is used principally 
to predigest foods, before they are given to the patient, in 
cases where the patient is unable to digest food. 

Pancreatin can only act in the presence of an alkali, and 
must always be given with sodium bicarbonate. 

It is seldom given internally, as it is destroyed by the 
hydrochloric acid in the stomach. 



86 MATERIA MEDICA 

When it is given internally, it should be given in pills 
coated with keratin, which is not acted upon by the acid of 
the gastric juice, but is dissolved by the alkaline intestinal 
juices. 

Preparations 

Pancreatin 0.1-0.3 gm. grs. ii-v 

(Pancreatinum) 

Unofficial Preparations 

Peptonizing Powder 

(Pulvis Pancreaticus Compositus) 

This is used to predigest foods such as milk and eggs. 
Each powder consists of 5 grains of pancreatic extract, 
and 15 grains of sodium bicarbonate. 

METHOD OF PEPTONIZING MILK 

Partially Peptonized Milk: 

To a bottle containing one pint of milk and 4 ounces of 
water, add one peptonizing powder. Keep the bottle at a 
temperature of 105 degrees to 115 degrees (Fahrenheit). 
This is best done by placing it in hot water of that temper- 
ature, for about 20 minutes to a half hour. The milk should 
then have a slightly bitter taste. Part of the proteids of 
the milk are digested by this method. 

Completely Peptonized Milk: 

The method for complete peptonization, is the same as 
for partial peptonization, but it is continued for two hours, 
during which time all the proteids are completely digested. 
Completely peptonized milk has an extremely bitter taste. 

Diazyme Essence 4.0-8.0 c.c. 5i-ii 

This is a liquid containing all the amylopsin of the pan- 
creas. It is used to digest starchy foods, when these are not 
readily digested by the saliva or pancreatic juice. 

Diazyme Glycerole 4.0-8.0 c.c. 3i-ii 

This acts like the diazyme essence. 



GASTRIC STIMULANTS 87 

Giycerole Trypsin: By mouth 4.0-8.0 c.c. 5i-ii 

Hypodermically 0.3 c. c. (m. v.) every other day. 

This preparation is given by mouth, or hypodermically 
for the treatment of cancer. It is supposed to digest the 
cancer cells. 

Holadin: One capsule, three hours after meals. Each capsule 
(Extractum Pancreaticum Integrum) contains 0.2 gm. grs. iii 

This is an extract of the pancreatic glands which contains 
all the enzymes; trypsin, amylopsin and steapsin; and a 
milk curdling ferment. It is used in diseases where the food 
is not well digested. 
Panase 0.12-0.3 gm. grs. ii-v 

This is a combination of the digestive ferments of the 
pancreas, derived from the pancreatic gland of the pig. It 
is used where digestion is poor. 

Pankreon 0.25-1.0 gm. grs. iv-xv 

Tannin Pancreatin Compound for children 0.06-0.25 gm. grs. i-iv 

This is a mixture containing the trypsin, amylopsin and 
steapsin of the pancreatic juice, and about 8% of tannin. 

The action takes place in the intestines, and it aids diges- 
tion in diseases where the food is not thoroughly digested, 
because of deficient action of the pancreas. It is also used 
in diarrhoea, dysentery, marasmus, etc. 
Trypsin 0.12-0.3 gm. grs. ii-v 

This is the proteid digesting ferment of the pancreas. 

It is applied in solutions containing sodium bicarbonate, 
to diphtheritic, or other membranes. It is also given hypo- 
dermically, in cases of cancer, to digest the cancer cells. 

Ingluvin (Not official) 0.3-1.0 gm. grs. v-xv 

Ingluvin is the extract of a fowl's gizzard, and is occasion- 
ally used to aid in the digestion of proteids. 
Papain 

Papain the fruit of the Carica papaya, a tree growing in 
tropical countries. The juice of this fruit contains a fer- 
ment papain, papayotin or papoid which is used to aid the 
digestion of proteids. 



EMETICS 

Drugs which Produce Vomiting 

Vomiting is an act by which the stomach violently empties 
its contents. The strain of continued vomiting, usually 
makes the patient very weak, and often produces symptoms 
of collapse. 

The patient is then very pale, his skin is cold and covered 
with perspiration, his pulse is rapid, weak and thready, and 
he breathes slower and shallower, and his pupils are dilated. 
The patient usually complains of great weakness. 

Drugs Produce Vomiting in Two Ways 

1. By greatly increasing the activity of the lining mem- 
brane of the stomach (irritating), the muscular wall of the 
stomach contracts very forcibly, and empties the stomach of 
its contents. 

2. Some drugs after being absorbed into the blood, are 
carried by the circulation, to an area of gray matter in the 
medulla of the brain, and cause this part of the brain, whose 
function is to produce vomiting (the vomiting center), to 
send impulses to cause the muscle wall of the stomach to 
contract, and thereby produce vomiting. 

IPECAC 

A drug obtained from the roots of the Cephaelis ipeca- 
cuanha, a wild plant growing in Brazil, Colombia and other 
parts of South America. 

Its active principles are the alkaloids. 

Emetine 

Cephaeline 

Psychotrine 

Appearance of the Patient 

If a patient is given a moderately large dose of one of 
the preparations of ipecac, a very short time after the ad- 



GASTRIC STIMULANTS 89 

ministration, he feels nauseated and vomits profusely. The 
vomiting is usually accompanied by profuse secretion of 
saliva, of tears, and of mucus from the bronchi. Occasion- 
ally, if the entire amount of drug is not completely excreted 
in the vomited matter, it may cause profuse diarrhoea 
and symptoms of mild collapse; rapid pulse, slower respira- 
tion, and cold moist skin. 

ACTION 

Local Action: On the skin it produces redness, itching 
and small pustules. 

On the mucous membranes : On the eye it causes redness and 
swelling with profuse flow of tears. In the nose it causes 
redness and profuse secretions and continual sneezing. 

Internal Action 

In the mouth: It increases the flow of saliva, and reddens 
the lining membrane. 

In the stomach: Ipecac acts principally on the lining 
membrane of the stomach, causing redness and swelling 
(irritation) with an excessive secretion of gastric juice, and 
mucus. This causes the muscle wall of the stomach to con- 
tract violently, thereby producing vomiting. The vomit- 
ing continues, until all the ipecac in the stomach is entirely 
expelled. 

In the intestines: The action on the intestinal tract is 
similar to that in the stomach, the lining membrane becomes 
red, swollen and secretes an excessive amount of mucus, 
thereby producing contractions of the muscle wall of the 
intestines which results in profuse diarrhoea. The stools 
often contain blood, from the excessive irritation. 

Action after Absorption 

Some of the ipecac is rapidly absorbed from the stomach. 
Ipecac then acts principally on all the mucous membranes. 
On the mucous membrane of the bronchi, it causes a profuse 
secretion of mucus. (It is commonly given for this effect, 
especially to children, in cough mixtures; to increase the 
expectoration). 



90 MATERIA MEDICA 

On the mucous membrane of the eye and nose it produces 
the same effects as when applied locally. 

The symptoms of collapse, which occasionally result after 
large doses of ipecac, are usually due to the great strain of 
continual vomiting. 

Excretion 

Ipecac is usually excreted by the stomach in the vomited 
matter, and does not therefore produce any poisonous symp- 
toms. 

Preparations 

Solid Preparations: 

Powdered Ipecac, as emetic 2.0 gms. grs. xxx 

(Pulvis Ipecacuanhae) as expec- 
torant 0.06-0.3 gm. grs. i-v 

Powdered Ipecac and Opium 0.3 -1.0 gm. grs. v-xv 

(Pulvis Ipecacuanhae et Opii) 
(Dover's powder) 

(Contains 10% opium and 10% ipecac) 

Fluid Preparations: 

Fluidextract of Ipecac, as emetic 1.0-2.0 c.c. m. xv-xxx 

(Fluidextractum Ipecacuanhae) as 

expectorant 0.2-0.5 c.c. m. iii-viii 

The following two preparations are given mostly to chil- 
dren. 

Syrup of Ipecac, for infant as 

emetic 2.0-4.0 c.c. 5-J-i 

(Syrupus Ipecacuanhae) as ex- 
pectorant 0.1-1.0 c.c. m. ii-xv 
(7% of fluidextract) 

Wine of Ipecac, for a child as 

emetic 2.0^.0 c.c. 5i~i 

(Vinum Ipecacuanhae) as expec- 
torant 0.1-1.0 c.c. m. ii-xv 

(10% of fluidextract) 

Active Principles 
Emetine (not ofiicial) 0:005-0.01 gm. gr. T y-J 



GASTRIC STIMULANTS 91 

Administration 

If given to produce vomiting, it is best to dilute the prepa- 
rations in warm water. 

If given as an expectorant, especially to croupy children, 
the preparations should be given undiluted. 

APOMORPHINE 

Apomorphine is an artificial alkaloid, made from morphine, 
one of the alkaloids of opium, by adding an acid to it, to 
take out some of the water that the morphine contains 
(such a process is called dehydration). 

Appearance of the Patient 

When a moderate dose of apomorphine is administered 
hypodermically, within ten to fifteen minutes after it is given, 
the patient feels very nauseated and vomits profusely. At 
the same time, there is profuse secretion of tears, mucus 
from the nose and bronchi, and cold perspiration. These 
symptoms are always produced by any drug which causes 
vomiting. There is usually a great deal of weakness after 
apomorphine, at times very profound collapse; a rapid thready 
pulse, slow and shallow respiration, cold perspiration and 
dilated pupils. The collapse however, has seldom been fatal. 

ACTION 

Apomorphine has no local action. 

Internally: Small doses of apomorphine often increase 
the secretions of all the mucous membranes without produc- 
ing vomiting, and they are often given for this effect. 

Mode of action: Apomorphine produces vomiting, by 
causing the vomiting center in the brain to send impulses 
to the stomach to cause its muscle wall to contract and 
thereby expel its contents. 

Excretion: It is excreted by the stomach in the vomited 
matter. 

Preparations 

Apomorphine Hydrochloride, as 

emetic, 0.006-0.012 gm. gr. T V - i 



92 MATERIA MEDICA 

(Apomorphinae Hydrochloridum) 

as expectorant 0.002-0.004 grs. ^V ~ iV 

Apomorphine is usually given hypodermically. 

SINAPIS— MUSTARD 

There are two kinds of mustard: 

Sinapis Alba (White Mustard) 
Sinapis Nigra (Black Mustard) 

Mustard is the powdered dried ripe seeds of Brassica 
alba and Brassica nigra, which are European plants grow- 
ing in temperate climates, throughout the world. 

Black mustard is usually much stronger than the white. 

ACTION 

Local Action: Applied to the skin, mustard causes redness, 
and the skin feels warm (rubefacient action), because it 
widens the capillaries. If the application is left on for a 
long time, or if the preparation is very strong, blisters are 
formed (vesicant action). If the application is kept on for 
a still longer time, pustules may form, and the skin may even 
be destroyed at the spot of application (escharotic action). 

Internal Action 

In the stomach, small quantities of mustard increase the 
appetite and the secretion of gastric juice, and therefore 
aid the digestion of food. For this purpose, mustard is 
never prescribed, but it is commonly used as a condiment 
with food. 

In doses in which mustard is usually prescribed, it produces 
nausea and vomiting, and is used extensively for this pur- 
pose, especially in cases of poisoning from various drugs. 

Since it produces vomiting in moderate doses, mustard 
is not absorbed, and produces no other effects, than those 
due to the vomiting. 

Preparations 

White Mustard powder 
(Sinapis Alba) 



GASTRIC STIMULANTS 93 

Black Mustard powder 
(Sinapis Nigra) 

Mustard Paper, or mustard plaster 
(Charta Sinapis) 

This consists of black mustard powder, to which India rubber 
is added to make it more adhesive, and the mixture is then applied 
to sheets of paper and dried. 

The active principles of black mustard are sinigrin, a 
glucoside, and myrosin, a ferment. 

When water is added to black mustard, it is decomposed; 
the myrosin acts on the sinigrin and changes it to dextrose, 
a sugar, and the volatile oil of mustard, which is the active 
ingredient. 

The active principles of white mustard are sinalbin, a 
glucoside, and a ferment myrosin. 

When water is added to white mustard it is decomposed. 
The myrosin acts on the sinalbin, changing it to dextrose, 
a sugar, and an alkaloid, sinapine sulphate. 

Mustard paste is commonly used as a local application 
to cause redness of the skin over which it is applied, in order 
to draw blood from the deeper tissues or organs (counter 
irritant) . It is usually made up with flour, usually one part of 
mustard to four parts of flour is used. It must be made up 
with tepid water, as hot water, alcohol and vinegar, destroy 
the oil which is formed and which is the active ingredient; 
so that no effect is then produced from the application. 

Methods of Administration 
For Local Applications : 

(1) The plaster dipped in lukewarm water is used. 

(2) Mustard paste : This should not be applied directly to 
the skin, but through a piece of thin gauze or lint. 

(3) Powdered mustard may be sprinkled over an ordinary 
poultice, and the poultice then applied to the skin. 

Local applications of mustard should not be left on longer 
than fifteen to thirty minutes. 

Mustard Baths are common methods of administering 



94 MATERIA MEDICA 

mustard for a local effect, and to relieve congestion of internal 
organs. About two to four teaspoonfuls of the dried powder 
are added to each gallon of water. 

To produce vomiting, a teaspoonful to a tablespoonful of 
the mustard powder is given in tepid water, and is repeated 
in fifteen to twenty minutes if no effects were produced. 

Poisonous Effects 

Large doses of mustard cause violent pain in the abdomen, 
with profuse vomiting and diarrhoea, and as a result of this, 
the symptoms of collapse; cold moist skin, pallor, rapid 
thready pulse, shallow breathing, and dilated pupils. 

ANTIMONY 

Antimony is a metal. Many of its preparations are used 
in medicine, principally to produce vomiting. 

ACTION 

Applied to the skin, antimony causes redness, and in strong 
solutions it produces blisters or pustules. 

When given internally, it causes profuse continuous vomit- 
ing and it increases the secretions of all the mucous mem- 
branes and the sweat. On account of the collapse which 
follows its use, it is not often used. 

Overdoses usually cause profuse vomiting and diarrhoea, 
with profound collapse. 

Preparations 

Tartar Emetic, as a diaphoretic 0.002-0.008 gm. grs. A - i 
Antimonii et Potasii Tartaras 

as an emetic 0.03 -0.1 gm. grs. |-ii 

This preparation is also contained in the compound 

syrup of squills. 

Wine of Antimony, as a diaphoretic 0.6- 2.0 c.c. m.x-xxx 
Vinum Antimonii as an emetic 4.0-15.0 c.c. 5i-iv 

Contains 4 parts of Tartar Emetic to 1000. 



GASTRIC STIMULANTS 95 

Other drugs used to produce vomiting, are : 

Zinc Sulphate 0.6-2.0 gms. grs. x -xxx 

Copper Sulphate 0.2-0.3 gm. grs. iii-v 

Copper sulphate is the best emetic to use in cases of 
Phosphorus poisoning. 

Alum 4.0 gms. 3i 

Alum is best given in molasses or in the syrup of ipecac. 

Turpeth Mineral (Yellow Mercurous Subsulphate) 

Hydrargyri Subsulphas Flavus 

(not official) 0.06-0.3 gm. grs. i-v 

It is given every ten or fifteen minutes until free vomiting 
occurs. 

Other substances used to produce vomiting are warm 
water given continuously until vomiting is produced. 

Salt (sodium chloride) is given in solid form or in concen- 
trated solutions. 



CHAPTER VII 

INTESTINAL STIMULANTS 

CATHARTICS 

Cathartics are drugs which are used to move the bowels. 
Many drugs which produce various effects on the different 
organs of the body, may also increase the movements of the 
bowels, but the drugs here considered, are those which are 
principally used to produce movements of the bowels. 

Movements of the bowels are brought about by the con- 
tractions of the involuntary muscles of the intestines (per- 
istalsis). 

This is caused, 

1. By the intestines filling up with either solid, fluid or 
gaseous matter, which is then expelled by the contractions 
of the intestinal muscles which the distention produces. 

2. By drugs which cause redness and swelling of the mucous 
membrane of the intestines (irritation). This not only 
causes an increased secretion of mucus, which helps to fill 
up the intestines, but also affects the nerve endings in the 
wall of the intestines. 

Impulses are thus sent along the nerve fibers to the 
spinal cord, which immediately sends back other impulses 
to the intestinal muscles to cause them to contract, and 
thus helps to expel the intestinal contents. (Such an action 
is called a reflex action). 

Frequent movements of the bowels are often accom- 
panied by violent cramp-like pains in the abdomen (griping), 
due to the violent contractions of the involuntary muscles 
of the intestines which accompany such movements. 

To overcome the griping, many cathartics are often com- 
bined with other drugs which lessen intestinal peristalsis. 

For example — Lapactic pills are commonly used cathar- 

96 



INTESTINAL STIMULANTS 97 

tics which are very efficient. They contain the extract of 
belladonna to overcome the griping which they might other- 
wise produce. 

3. Many cathartics, like the salines, draw fluid into the 
intestines from other tissues and from the blood; thereby 
filling up the intestines with fluid which is expelled by the 
resulting contractions of the intestinal muscles. 

At the same time, this removes fluids from other tissues 
and from the blood, so that oedema (fluid in the tissues) 
may be lessened and the blood pressure reduced. 

Saline cathartics are often given to produce these effects. 

Administration 

Cathartics which produce mild effects, or which produce 
their effects slowly, should be given at night. 

Those which produce rapid effects, should be given in the 
morning. 

Cathartics which cause violent action should not be given 
in cases where the intestine is diseased. 

For example — In typhoid fever, or acute appendicitis violent 
cathartics should be avoided. In typhoid fever an active 
cathartic may increase the inflammation in the ulcers which 
are present in the intestinal mucous membrane in this disease. 
The violent contractions which such a cathartic produces, 
may increase the tendency to haemorrhage and perforation. 

In cases of acute appendicitis the appendix may be very 
friable, and the violent contractions which many cathar- 
tics produce, may cause a rupture of the appendix. 

In cases that have had an abdominal operation performed 
upon them, the nurse should never administer a cathartic with- 
out the doctors order. 

When the operation has been performed upon the stomach 
or intestines, such operations as the removal of the verm- 
iform appendix, the removal, or suturing (sewing) of a part 
of the stomach and intestines, the greatest care must be 
exercised in giving cathartics. In such cases no cathartic 
should be administered before the third day after the opera- 
tion, because the violent intestinal contractions may tear 



98 MATERIA MEDICA 

the delicate stitches in the wall of the intestines, and cause 
perforations with resulting peritonitis, and even fatal results. 

Cathartics are divided into three classes, depending upon 
whether they cause mild action, moderate action, and more 
violent action. 

The distinction is not very well defined; as some cathartics 
produce mild effects in small doses, and greater, even violent 
effects in larger doses, but the classification here given, is 
according to the effects produced by the doses that are 
usually administered. 

1. Laxatives 

2. Purgatives (Vegetable and Saline Purgatives) 

3. Drastic Purgatives 

1. Laxatives or Aperients: Laxatives are medicines which 
cause a few movements of the bowels. The stools are 
formed, normal in character, and the movements are not 
accompanied by griping. 

LAXATIVES 

Many foods which leave a great deal of residue or un- 
digested material, after they are digested, act as laxatives. 
Such foods as oatmeal, wheat, bran and many fruits are 
distinctly laxative. The most common laxatives used are: 

Molasses 
(Syrupus Fuscus) 

Milk Sugar 
(Saccharum Lactis) 

MANNA: Manna is a drug obtained from the sap of the 
European ash tree which grows chiefly in Sicily and Cala- 
bria. 

Dose : 15.0-60.0 gms. 3 -J-5 ii 

Manna is used as a mild laxative, very often combined 
with other purgatives. 

FRANGULA: Frangula is obtained from the bark of the 
European buckthorn or Rhamnus frangula. 



INTESTINAL STIMULANTS 99 

Preparations 

Fluidextract of Frangula 1.0-2.0 c.c. m. xv-xxx 

(Fluidextractum Frangulae) 

Frangula contains an active principle frangulin, a glu- 
coside. 

CASCARA: Cascara sagrada is obtained from the bark of 
the California buckthorn. Its official name is Rhamnus 
purshianae. It contains an active principle purshianin, a 

glucoside. 

Preparations 

Extract of Cascara Sagrada 0.25 gm. grs. iv 

(Extractum Rhamni Purshianae) 

Fluidextract of Cascara Sagrada 1.0 c.c. m. xv 

(Fluidextractum Rhamni Purshianae) 

Cascara is one of the best laxatives. It is usually given 
at night, and produces a normal stool the next morning 
without griping. It is often given for habitual constipation. 

FEL BOVIS or ox gall: Fel bovis is dried bile, obtained 
from the ox. It is used as a mild laxative and to increase 
the flow of bile. 

Preparations 
Purified Ox gall 0.3-1.2 gm. grs. v-xx 

(Fel Bovis Purificatum) 

EUONYMUS : Euonymus or Wahoo, is the bark of tjie Eu- 
onymus atropurpureus, the spindle tree, growing in America. 
It is' used as a mild laxative. 

Preparations 
Extract of Euonymus 0.06-0.2 gm. grs. i-iii 

(Extractum Euonymi) 

Fluidextract of Euonymus 0.5 c.c. m. viii 

(Fluidextractum Euonymi) 

LEPTANDRA: Leptandra is obtained from the roots and 
underground roots of the Veronica Virginia, an American 
plant. 



100 MATERIA MEDICA 

It is used as a mild laxative. The stools often contain 
a great deal of bile after it is given. 

Preparations 

Extract of Leptandra 0.1-0.25 gm. grs. ii-iv 

(Extractum Leptandrae) 

Fluidextract of Leptandra 2.0-1.0 c.c. m. xxx-5i 

(Fluidextractum Leptandrae) 

TAMARIND: Tamarindus or tamarind is the preserved 
fruit of the tamarindus indica, a tree growing in the East or 
West Indies. It is eaten like preserves, and is a very good 
laxative. 

CASSIA FISTULA: Cassia fistula, or purging cassia, is the 
fruit of the cassia fistula tree of East India and Egypt. 
It is used as a laxative in doses of 

4.0-30.0 c.c. 5i-3i 

SULPHUR (Brimstone) is an inorganic element found in 
volcanoes. Many of its preparations are used as laxatives. 

Washed Sulphur 1.0-4.0 gms. grs. xv-5i 

(Sulphur Lotum) 

Precipitated Sulphur 4.0-15.0 gms. 3i -iv 

(Sulphur Praecipitatum) 

Sublimed Sulphur, or flowers of Sulphur 

(Sulphur Sublimatum) 4.0-15.0 gms. 5i - iv 

Sulphur is best given in syrup. 

Glycerin 
Glycerin 
(Glycerinum) 

Glycerin in doses of one to two ounces is a very good 
laxative. 

Olive Oil 
Olive Oil 
(Oleum Olivae) 

Olive oil in doses of a wineglassful acts as a very good 
laxative. It is said to increase. the flow of bile. 
Plenty of water is also a very good laxative. 



INTESTINAL STIMULANTS 101 

PURGATIVES 

Purgatives are drugs which produce frequent movements 
of the bowels, with soft stools accompanied by griping. 
There are two kinds of purgatives. 

1. Vegetable purgatives: Vegetable purgatives are vege- 
table substances causing frequent movements of the bowels. 

2. Saline purgatives : Saline purgatives are inorganic (min- 
eral) salts used as purgatives. 

These are often called hydragogue cathartics because they 
produce very frequent watery stools. 

Many purgatives are also called cholagogue cathartics 
because the stools which they produce are highly colored 
with bile. This is due to the fact, that they act mainly on 
the duodenum or first part of the small intestine, and there- 
fore also bring about contractions of the bile ducts, so that 
more bile is poured into the intestine. They do not increase 
the secretion of bile. 

VEGETABLE PURGATIVES 

Large doses of the laxatives act as purgatives. 

CASTOR OIL— OLEUM RICINI 

Castor oil is a fixed oil (an oil which does not evaporate), 
obtained from the seeds of the Ricinus communis, a tree 
growing in all warm countries. The seeds are warmed, and 
the oil is then pressed out of them. The oil ordinarily used, 
is obtained from Calcutta in India. 

Castor oil has no odor, but a very unpleasant nauseating 
taste. 

The active principle of castor oil is ricinoleic acid, and its 
compounds ricinoleates. These are formed in the stomach 
when castor oil is given. Old castor oil contains more rici- 
noleic acid, and is therefore often more efficacious. 

ACTION 

Local Action: On the skin and mucous membranes, castor 
oil is very soothing. 



102 MATERIA MEDICA 

Internal Action 

In the mouth: It has an unpleasant nauseating taste. 
Even the smell of it will sometimes produce nausea. 

In the intestines: Castor oil produces in about three to 
six hours, frequent movements of the bowels, not ac- 
companied by griping. The stools are soft, and after the 
movements have occurred, the bowels are apt to be con- 
stipated. 

The castor oil is decomposed by the digestive juices, so 
that ricinoleic acid and its compounds are formed (ricino- 
leates). These substances slightly increase the intestinal 
secretions, and affect the nerve endings of the intestinal 
wall. Impulses are thus sent to the spinal cord, to bring 
about contractions of the muscle wall of the intestines, 
thereby causing frequent movements of the bowels (reflex 
action). 

The ricinoleates which are formed in the intestine, are 
absorbed into the blood, and are then excreted by all the 
secretions, including the milk, so that castor oil often acts 
as a laxative on nursing infants. 

Castor oil is one of the best cathartics for temporary 
use; because of its soothing after effect which produces con- 
stipation. 

Preparations 

Castor Oil 15.0-30.0 c.c. 5H 

(Oleum Ricini) 
For an infant 4.0- 8.0 c.c. 5i-ii 

Laxol: This is a tasteless preparation of castor oil (not 
official). 

Castor oil is also put up in flexible capsules, to disguise 
its unpleasant taste. 

(The castor oil bean contains a very poisonous substance, 
ricin, which is never used.) 

Administration 

On account of its unpleasant taste, castor oil must be 
given very carefully. 

To some people, however, the taste of castor oil is not 



INTESTINAL STIMULANTS 103 

at all unpleasant. For example: the Chinese are very fond 
of castor oil and do not mind its unpleasant taste, in fact, 
they use it as a food. 

Methods of Administration 

1. To children or even to some adults, it may be given 
in warm sweetened milk. 

2. It may be poured in an equal quantity of glycerin and 
given in this manner. 

3. It is often given in hot coffee. 

4. In soda water its taste can often be easily disguised. 

5. It is often given in brandy. 

The best method, however, is the following: 

Castor Oil Cocktail 

Rinse out the medicine glass with some whiskey or lemon 
juice, and pour about a teaspoonful of whiskey or lemon 
juice in the bottom of the glass. The castor oil is then 
added; and on top of that, another teaspoonful of whiskey, 
raspberry juice or peppermint. The mixture is then given 
to the patient. 

The patient's mouth may be rinsed out with a little whis- 
key or peppermint, before giving the castor oil. 

A little vichy or seltzer, or an olive, will often remove 
the unpleasant nauseous feeling which follows the taking of 
a dose of castor oil, even when its taste is disguised. 



CALOMEL: HYDRARGYRI CLORIDI MITE 

Calomel is a compound of mercury; the mild mercurous 
chloride. 

ACTION 

Calomel is used principally as a purgative. It produces 
frequent soft stools, very highly colored with bile, and it 
is often called therefore, a cholagogue cathartic. 

It acts principally on the duodenum; the first part of the 
small intestine. It acts as an antiseptic in the intestines, 
checking the growth of bacteria. It also causes redness, and 



104 MATERIA MEDICA 

increased secretion of the lining membrane of the intestines 
(irritation), which brings about contractions of its muscle 
wall (peristalsis). The contractions of the intestinal muscle 
wall, induce contractions in the bile ducts, which are closely- 
attached to the duodenum or first part of the small intestine. 
These contractions increase the flow of bile into the intestine, 
so that the stools produced by calomel, contain a great deal 
of bile. 

Calomel has a decided tendency to produce griping. 

It is also used to increase the flow of urine, (diuretic) 

Preparations 

Calomel 0.008-0.3 gm. gr. f-v 

(Hydrargyri Chloridi Mite) 

Administration 

Calomel may be given in small doses, frequently repeated. 
For example — \ of a grain every fifteen minutes until two 
grains are taken, or the two grains may be given in one single 
dose. 

It is often given with sodium bicarbonate; about five 
grains of sodium bicarbonate with every half grain dose of 
calomel. This lessens the griping, and also neutralizes the 
action of the acid in the stomach, which often changes 
calomel (mild mercurous chloride) to corrosive sublimate 
(bichloride of mercury) which is a distinct poison. 

Calomel should always be followed by a dose of one of 
the saline cathartics, to expel it; as it might otherwise re- 
main in the intestines and be changed into corrosive subli- 
mate which may then cause poisonous symptoms. These 
symptoms are: A metallic taste in the mouth, abdominal 
pain, nausea, vomiting, diarrhoea with bloody stools, and 
collapse (rapid weak thready pulse, slow shallow respiration, 
cold moist skin, dilated pupils). 

BLUE MASS— MASSA HYDRARGYRI 

This is a compound of mercury and is a milder purgative 
than calomel. It is always given in pill form, each pill 
containing about three to five grains of the blue mass. 



INTESTINAL STIMULANTS 105 

Blue Mass 0.06-0.3 gm. grs. i-v 

(Massa Hydrargyri) 

MERCURY WITH CHALK, GRAY POWDER, HYDRARGY- 
RUM CUM CRETA 

This preparation is made of metallic mercury, with chalk 
and honey. 

It is always prescribed in powder form. It is milder than 
calomel. The chalk lessens the griping. 

RHUBARB 

Rhubarb is obtained from the root of the Rheum officinale, 
a plant growing in China and Tartary. 

ACTION 

In the stomach: Rhubarb increases the secretion of 
gastric juice, thereby aiding digestion, and increasing the 
appetite. In the intestines rhubarb acts as a purgative, 
producing frequent fluid stools, not accompanied by griping. 
These stools are colored with a great deal of bile. 

On account of the tannic acid which it contains, rhubarb 
constipates after its purgative action. 

The urine, and in nursing women, the milk, is colored 
yellow when rhubarb is taken. 

Rhubarb is particularly valuable in cases where solid 
masses in the stools produce pain. For example, in haemor- 
rhoids, by softening the stools, the pain produced by the 
passage of hard fecal masses, is often relieved. 



Preparations 




Extract of Rhubarb 
(Extractum Rheii) 


0.3-0.6 gm. 


grs. v-x 


Fluidextract of Rhubarb 
(Fluidextractum Rheii) 


1.0-2.0 c.c. 


m. xv— xxx 


Compound Rhubarb Pill 1 -5 pills 
(Pilulae Pheii Compositae) 

(Contains aloes, myrrh, oil of peppermint and rhubarb) 



106 MATERIA MEDICA 

Compound Rhubarb Powder 1.0-4.0 gms. grs. xv-5i 
(Pulvis Rheii Compositus) 

(Gregory's powder) 

(Contains magnesia, ginger and rhubarb) 

Aromatic Tincture of Rhubarb 2.0-8.0 c.c. 5 ss-ii 
(Tincture Rheii Aromatica) 

Rhubarb and Soda Mixture 4.0-16.0 c.c. 3 i -iv 

(Mistura Rheii et Sodae) 

(Contains bicarbonate of soda, ipecac, peppermint and glycerin) . 

Syrup of Rhubarb 2.0- 8.0 c.c. 3 ss-ii for a 

(Syrupus Rheii) child. 

Aromatic Syrup of Rhubarb 2.0- 8.0 c.c. 3 ss-ii for a 

(Syrupus Rheii Aromaticus) child. 

ALOES 

Aloes is the dried juice of several species of Aloes, a plant 
growing in the Barbadoes, and other islands in the Indian 
Ocean and in Arabia. It is one of the oldest drugs in medi- 
cine. It was used in the time of Alexander the Great, about 
300 years B. C. 

The preparations used, are the Barbadoes and Socotrine 
Aloes, from the Barbadoes, and the Island of Socotra. 

Its active principle is a neutral substance, Aloin. 

ACTION 

In the stomach: Aloes increases the secretion of gastric 
juice, aids digestion and increases the appetite. 

In the intestines: Aloes acts principally on the large 
intestine, causing marked redness, with great dilatation of 
the blood vessels. This action results in peristalsis of the 
large intestine. 

Aloes therefore causes movements of the bowels, with 
frequent formed stools. 

It also dilates the blood vessels of the other organs in the 
pelvis, such as the uterus, bringing more blood to these 
organs, increasing menstruation and often producing abor- 
tion. 



INTESTINAL STIMULANTS 107 

Administration 

Aloes is seldom administered alone. It is usually given 
combined with other purgatives. 

Preparations 
Solid Preparations 

Purified Aloes 0.1-0.5 gm. grs. ii-viii 

(Aloe Purificata) 

Extract of Aloes 0.1-0.5 gm. grs. ii-viii 

(Extractum Aloes) 

Pills of Aloes 1 -5 pills 

(Pilulae Aloe) 

Each pill contains 0.12 gm. grs. ii of aloes 

Pills of Aloes and Iron 1 -5 pills 

(Pilulae Aloes et Ferri) 
Each pill contains 0.12 gm. grs. ii of aloes 

Pills of Aloes and Mastiches 1 -5 pills 
(Pilulae Aloes et Mastiches) 

(Lady Webster's dinner pill.) Each pill contains grs. ii of aloes 

Pills of Aloes and Myrrh 1 -5 pills 

(Pilulae Aloes et Myrrhae) 

(Rufus pill.) Each pill contains 0.12 gm. grs. ii of aloes 

Fluid Preparations 

Tincture of Aloes 2.0 -8.0 c.c. 5 ss-ii 

(Tinctura Aloes) 

Tincture of Aloes and Myrrh 2.0 -8.0 c.c. 3 ss-ii 

(Tinctura Aloes et Myrrhae) 

Aloin (active principle) 0.06-0.25 gm. grs. i -iv 

(Aloinum) 

Lapactic Pills or A. B. & S. pills dose 2 pills 
Pilulae Laxativae Compositae 

Each pill contains, 

Aloin gr. \ 

Extract of Belladonna gr. \ 

Strychnine gr.rib 

Powdered Ipecac gr. T V 



108 MATERIA MEDICA 

Aloes is also contained in the compound rhubarb pill, com- 
pound extract of colocynth, and compound tincture of benzoin. 

SENNA 

Senna is obtained from dried small leaves of an oriental 
shrub. 

There are two kinds of senna plants, Cassia acutifolia, which 
comes from Alexandria in Egypt and Cassia angustifolia, from 
India. Senna contains several active principles, cathartic 
acid, chrysophanic acid, sennit and sennacrol 

ACTION 

Senna acts principally on the large intestines, producing 
in five hours after it is given, frequent watery stools, usually 
accompanied by severe griping pains. 

To overcome the griping, it is usually combined with other 
substances, especially carminatives. 

It is excreted in the urine. In nursing women it is excreted 
in the milk, and it will then act as a laxative on the nursing 
infant. 

Senna in small doses is often given to children to produce 
a laxative effect. 

Preparations 
Fluidextract of Senna 4.0-8.0 c.c. 5i-ii 

(Fluidextractum Sennae) 

Confection of Senna 4.0-8.0 c.c. 5i-ii 

(Confectio Sennae) 

Containing senna, cassia fistula, tamarind, prune, fig, sugar 
and oil of coriander. 

Compound Infusion of Senna (Black Draught) 

(Infusum Sennae Compositum) 30.0-120.0 c.c. §i-iv 

Contains senna, manna, magnesium sulphate and fennel. 

Syrup of Senna 4.0-16.0 c.c. 5i-iv 

(Syrupus Sennae) 

Senna tea is a preparation often given to children. It is 
an infusion of senna leaves, a teaspoonful of leaves are used 
to a cup of water. 



INTESTINAL STIMULANTS 109 

GLYCYRRHIZA, LICORICE ROOT 

Licorice is the root of Glycyrrhiza glabra, an English plant. 
Its active principle is a glucoside, glycyrrhizin. 

ACTION 

Applied to the skin it is soothing and protecting (demul- 
cent). Taken internally it is a mild purgative. 

Preparations 

Compound Licorice Powder 4.0 gms. 5 • i 

(Pulvis Glycyrrhizae Compositus) 

This contains senna, licorice root, sulphur, fennel and 
sugar. It should be given in very little water, as it often 
causes nausea, but it should always be followed by a drink 
of water. 

Licorice powder is best given at bedtime. It is an excellent 
purgative, producing frequent fluid stools without griping, 
in about ten to fifteen hours; or three to six hours, if given 
on an empty stomach. 

It is especially valuable in patients suffering from haemor- 
rhoids. The fluid stools which licorice powder produces, 
lessens the pain which movements of the bowels cause in 
haemorrhoids. 

NEW AND NON-OFFICIAL PREPARATIONS 
PHENOLPHTALEIN 

Phenolphtalein is a chemical substance made from car- 
bolic acid, phthalic anhydride and sulphuric acid. 

It is used in the laboratory to test the reaction of various 
substances; since it turns red when an alkali is added to it. 

ACTION 

Phenolphtalein acts as a very good purgative, producing 
frequent soft stools with little griping. 

Preparations 
Phenolphtalein 0.1-0.2 gm. grs. ii-iii 



110 MATERIA MEDICA 

In obstinate cases of constipation, it may be given in doses 
of 0.5 gm. (grs. viii). 

It is best given in powders, cachets, capsules or pills. 

There are numerous preparations of phenolphtalein on 
the market which are used as purgatives such as ex lax, 
chocolax, etc. 

AGAR AGAR 

Agar agar is a substance extracted from various sea 
weeds of the East Indies. 

It is used as a purgative. It withdraws water from the 
stomach and intestines, forming a large jelly-like mass, 
which is indigestible, and increases the size of the fecal 
masses, so that the intestines become distended. 

The distention of the intestines produces frequent strong 
contractions of its muscle wall (peristalsis), which result in 
frequent movements of the bowels. 

It is given in milk, and is eaten like oatmeal gruel or any 
other cereal. 

Preparations 

Agar Agar 4.0-15.0 gms. 5H5i 

Regulin, is a preparation of agar agar with cascara, and 
is given in the same doses. 

Agar Agar with Calumba 
Agar Agar with Gentian 
Agar Agar with Phenolphtalein 

(Einhorn) 

HORMONAL (Peristaltic Hormone, Zuelzer) (not official) 

Hormonal is the extract in normal salt solution, of the 
spleen of an animal that is killed at the time when its di- 
gestive processes are most active; usually about an hour after 
being fed a heavy meal. The guinea pig's spleen is used 
in making the extract. 

It is usually given by injecting the preparation directly 
into a vein (intravenously) or into the muscles (intramuscu- 
larly). 



INTESTINAL STIMULANTS 111 

ACTION 

About two to twenty-six hours after injecting hormonal, 
the patient begins to have frequent movements of the bowels. 
The stools are formed, and accompanied by little griping. 
After that, he has about one or two normal stools regularly, 
for a few days. Occasionally, there is a slight rise of temper- 
ature and pain at the spot of injection, which lasts for about 
twenty-four hours. 

Mode of Action 

Hormonal is a substance which is manufactured by the 
lining membrane of the stomach, at the time when digestion 
is greatest. This substance enters the blood stream, which 
carries it to the spleen and it is there stored up. The spleen 
then secretes this substance again into the blood stream, and 
it is then carried to the muscle wall of the intestines, increas- 
ing its contractions (peristalsis), which then cause movements 
of the bowels. 

Preparations 

Hormonal Intramuscular 20.0 c.c. 5v 

(A preparation of hormonal for intramuscular use. It usually 

comes in blue bottles.) 

Hormonal Intravenous 20.0 c.c. 5v 

(A preparation for intravenous use. It usually comes in brown 

bottles.) 

Uses 

Hormonal is used in obstinate cases of constipation. It 
is also used in patients who have been operated upon, and 
who have difficulty in moving their bowels, or passing gas 
after the operation. 

It is only given by intravenous or intramuscular injections. 

No preparation of opium or morphine, should be given 
before or after hormonal, as it neutralizes its effect. 

SALINE PURGATIVES 

Saline purgatives are inorganic (mineral), salts used as 
purgatives. They are all combinations of alkalies with 



112 MATERIA MEDICA 

acids. Only those salts are used, which are not absorbed 
in the doses given. 

Action 

Locally : The saline purgatives produce no effect. 

In the mouth: Most of them have a harsh unpleasant 
bitter taste. 

In the stomach : They often produce nausea and vomiting. 

In the intestines: They produce frequent fluid stools 
accompanied with griping. 

Mode of Action 

When given in small doses, so that the percentage of 
salt in the intestine is less than that in the blood (anisotonic), 
or equal to that in the blood (isotonic), the salts are not 
absorbed, but they prevent the passage of fluids through 
the lining membrane of the stomach and intestines (absorp- 
tion), so that the intestines, particularly the large intestine, 
fills up with fluid, and this produces contractions of its mus- 
cular wall, with resulting frequent fluid stools. 

When given in larger doses so that the percentage of salt 
in the intestines is greater than that in the blood (hyper- 
tonic), the salts are not absorbed, but they withdraw fluid 
into the intestines, from the blood and tissues, until the 
percentage of salt in the intestines is reduced to the same 
percentage as that in the blood. Then part of the salt is 
absorbed, and the rest helps to fill up the large intestine, 
and distend it. This distention causes peristalsis of the 
intestines, which produces frequent watery stools. 

The saline cathartics are particularly valuable in cases 
where there is a great deal of fluid in the tissues (oedema). 
For example — To reduce oedema of the legs in nephritis, 
or to reduce ascites (fluid in the abdomen). 

They withdraw the fluid from the tissues into the intes- 
tines, and the frequent movements of the bowels which 
they then produce, gets rid of this excessive fluid, and in 
this manner the saline cathartics relieve the oedema or 
ascites. 

They are also given to reduce the blood pressure, because 



INTESTINAL STIMULANTS 113 

they withdraw fluid from the blood, and thereby lessen the 
amount of blood, as a result of which, the blood pressure is 
reduced. 

The saline cathartics should not be given in cases where 
there are ulcers or inflammation in the intestines, as they 
aggravate this condition. 

A small portion of each dose of the salines is absorbed, and 
acts on the kidneys as a diuretic, increasing the flow of urine. 

Administration 

The saline cathartics are best given well diluted, pref- 
erably in the morning, when the stomach is empty. They 
move the bowels in a few hours. 

Preparations 
Salts of Sodium 

Sodium Sulphate (Glauber's Salt) 2.0-30. gms. 3 1-§ i 
(Sodii Sulphas) 

It is best given in solution, in vichy or seltzer, not stronger 
than 5-10%. 

It is soluble in 3 parts of water. 

Sodium Phosphate 1.0-30.0 gms. grs. xv-gi 

(Sodii Phosphas) 

This is best given in milk, not stronger than 5-10%. 
It is soluble in 6 parts of water. 

Salts of Potassium 

Potassium Sulphate 1.0-4.0 gms. grs. xv-3i 

(Potassii Sulphas) 

Potassium Bitartarate (Cream of tartar) 

(Potassii Bitartaras) 1.0-4.0 gms. grs. xv-5i 

Potassium and Sodium Tartarate (Rochelle Salt) 

(Potassii et Sodii Tartaras) 8.0-16.0 gm. 3ii-iv 

It is soluble in 1| parts of water. 

It tastes pleasanter than Epsom salts. 

These preparations are best given in cold seltzer or vichy. 



114 MATERIA MEDICA 

If they are given hot, the addition of 10 or 15 drops of 
tincture of ginger makes them taste more agreeable. 

They should not be given stronger than 5-10% solutions. 

Salts of Magnesium 

Magnesia Oxide or Calcined Magnesia, or light magnesia 
(Magnesii Oxidum) 4.0 gms. 3i 

Heavy Magnesia 

(Magnesia Oxidum Ponderosa) 4.0 gms. 5i 

Magnesia is very mild in action. 

Magnesium Sulphate (Epsom salts) 

(Magnesii Sulphas) 2.0-30.0 gms. 5|-Si 

It is soluble in 1 \ parts of water. 

Magnesium sulphate is very commonly used. It has a 
very unpleasant taste and is best given in seltzer or vichy. 

Large doses produce very rapid effects, with a good deal 
of griping. 

Magnesium Carbonate 4.0-8.0 gms. 5i-ii 

(Magnesii Carbonas) 

This preparation is not used very often. 
The preparations of magnesia are best given in powder 
form, sweetened to disguise the taste. 

Carlsbad Salt 
(Sal Carolinum) 

This is a mixture of the mineral salts obtained by evap- 
orating the water of the carlsbad mineral spring in Bohemia. 

Artificial Carlsbad Salt 
(Sal Carolinum Factitium) 

This is a mixture of the salts contained in natural carls- 
bad salts, and consists of 

Dried Sodium Sulphate 44 parts 

Potassium Sulphate 2 

Sodium Chloride 18 

Sodium Bicarbonate 36 

Artificial carlsbad water contains about 70 parts of this 
salt to 1000 c. c. of water. 



INTESTINAL STIMULANTS 115 



EFFERVESCENT PREPARATIONS 

These preparations of the salts, produce gas (effervesce), 
when dissolved in water. 

Seidlitz Powder 

(Pulvis Effervescens Compositus) 

This is made up in two powders, 

1. One powder wrapped up in blue paper contains: 

Sodium Bicarbonate 2.5 gms. grs. xl 

Rochelle Salts 

(Potassium and Sodium Tartarate) 8.0 gms. 5ii 

2. Another powder wrapped up in white paper contains: 

Tartaric Acid 1.5 gm. grs. xxv 

The seidlitz powder should always be made up at the 
bedside. Each powder should be dissolved in half a glass of 
water, and then the two solutions should be mixed; and the 
mixture given to the patient. 

The tartaric acid and sodium bicarbonate combine, and 
form carbon dioxide gas, which produces the effervescence. 
Seidlitz powder is often given to distend the stomach, for 
diagnostic purposes. 

Solution of Citrate of Magnesia 

(Liquor Magnesii Citratis) dose 150.0-360.0 c.c. Sv-xii 

This is a solution of magnesium citrate and citric acid, 
to which potassium bicarbonate is added. It is usually 
kept in tightly closed bottles, and effervesces when it is 
poured in a glass. 

Effervescent Magnesium Sulphate 15.0-30.0 gms. 5i~i 
(Magnesii Sulphas Effervescens) 

This contains epsom salts, sodium bicarbonate, tartaric 
and citric acids. The mixture effervesces when mixed with 
water. 

Effervescent Sodium Phosphate 8.0-15.0 gms. 3ii-5i 

(Sodii Phosphas Effervescens) 



116 MATERIA MEDIC A 

This contains sodium phosphate, sodium bicarbonate, 
tartaric and citric acids. The mixture effervesces when 
dissolved in water. 

Effervescent Lithium Citrate 4.0-8.0 gms. 3i-ii 

(Lithii Citras Effervescens) 

This contains lithium, citrate, or carbonate, sodium bi- 
carbonate and citric acid. 

All these effervescent preparations, if not already in 
solution, should be given in a tumbler of water. 

Many natural mineral waters are used as cathartics. 
The following are the most important ones: 

Hunyadi Janos (non-official) 

Carlsbad Water 

This contains magnesium and sodium sulphate, and other 
salts. 

Apenta Water (non-official) 

This consists mainly of sodium and magnesium sulphate 
with small quantities of sodium chloride and bicarbonate 
of soda. 

Pluto Water (non-official) 

This is obtained from the French Lick springs in Indiana, 
and consists mainly of sodium and magnesium sulphates 
with small quantities of sodium chloride, calcium, magne- 
sium and iron salts. 



DRASTIC CATHARTICS 

Drastic cathartics are drugs which produce frequent fluid 
movements of the bowels, accompanied by severe griping 
pains. 

They cause very severe action, at times the stools may 
even be tinged with blood, and may contain flakes of mucous 
membrane. 

When several drastic cathartics are given together, they 
are not so apt to cause violent action. 

In large doses, most of the drastic cathartics are violent 
poisons. 

The symptoms which such doses cause, are nausea, 
vomiting, abdominal pain and profuse diarrhoea. The stools 
contain blood and flakes of the lining membrane of the 
intestines, which is usually very severely inflamed by large 
doses of the drastic purgatives. In spots, the lining mem- 
brane may even be destroyed by such doses. 

Associated with these symptoms, the patient is usually in 
severe collapse. The skin is pale, moist and cold, the 
breathing is slow and shallow, the pulse is rapid thready 
and weak, the pupils are widely dilated, and the patient 
finally goes into coma and dies. 



JALAP— JALAPA 

Jalap is the root of the Ipomoea jalapa, a twining vine 
of Mexico. 

The active principles are two glucosides, jalapin and 
convolvulin. 

ACTION 

Local Action: on mucous membranes powdered jalap causes 
pain, redness and excessive secretion of mucus. 

Internal Action 

In the stomach, in ordinary doses, it increases the secretion 
of gastric juice. 

117 



118 MATERIA MEDICA 

Jalap acts principally on the intestines, increasing the se- 
cretions of its lining membrane and increasing the peristaltic 
contractions of its muscle wall. It also withdraws fluid 
from the blood and tissues, into the intestines. 

The result of this action is to produce frequent large 
watery stools, accompanied by griping. 

In addition to its drastic purgative action, it is used to 
relieve dropsy (fluid in the tissues), and ascites (fluid in 
the abdomen). 

Jalap is rarely given alone. It is usually combined with 
some other purgative, particularly calomel. 

Poisonous Effects 

In overdoses, jalap causes severe abdominal pain, vomiting, 
profuse diarrhoea and the symptoms of collapse. 

Preparations 

Jalap 0.3-1.0 gm. grs. v -xv 

(Jalapa) 

Resin of Jalap 0.1-0.3 gm. grs. ii -v 

(Resinae Jalapae) 

Compound Jalap Powder 1.0-4.0 gms. grs. xv-5i 

(Pulvis Jalapae Compositus) 

This contains jalap and cream of tartar. 

SCAMMONY (SCAMMONIUM) 

Scammony is the dried milky juice (resin), obtained from 
the root of the Convolvulus scammonia, a vine growing in 
Syria. 

Its active principle is mostly jalapin. 

ACTION 

Scammony is used principally as a drastic purgative. 
It acts like jalap, producing frequent copious fluid stools 
accompanied by griping. 

Scammony is frequently adulterated, and for this reason, 
the resin is the only preparation used, usually in combina- 
tion with other purgatives. 



INTESTINAL STIMULANTS 119 

Preparations 

Resin of Scammony 0.2-0.5 gm. grs. iii-viii 

(Resina Scammoniae) 

COLOCYNTH (COLOCYNTHIS) 

Colocynth is the pulp of the bitter cucumber or Citrullus 
colocynthis which grows on vines in Egypt, Syria, South 
Africa, Turkey and Japan. 

Its active principle is a glucoside colocynthin. 

ACTION 

Local Action: On mucous membranes colocynth causes 
pain, redness with profuse secretion of mucus. 

Internal Action 

In the stomach: Colocynth increases the secretion of gas- 
tric juice and the peristalsis. 

In the intestines: Colocynth acts principally on the in- 
testines, greatly increasing the secretions of the intestinal 
mucous membrane, and producing violent peristalsis. It 
also draws fluid from the tissues and blood into the intestines. 

The result of this action, is frequent movements of the 
bowels, with copious watery stools accompanied by griping. 

Poisonous Effects 

In large doses colocynth is an active poison, producing 
nausea, profuse vomiting, abdominal pain and very profuse 
diarrhoea. The stools contain blood and often flakes of 
the mucous membrane of the intestine. 

These symptoms are associated with profound collapse. 

The patient looks pale, the skin is cold and moist, the 
pulse is rapid, weak and thready, the breathing is slow and 
shallow and the pupils are widely dilated. 

These symptoms gradually become worse until death 
finally results. Frequent cases of colocynth poisoning have 
occurred. 

Colocynth is rarely given alone, but usually combined 
with other purgatives. 



120 MATERIA MEDICA 

Preparations 

Extract of Colocynth 0.1-0.3 gm. grs. ii-v 

(Extracturn Colocynthidis) 

Compound extract of Colocynth 0.2-1.0 gm. grs. iii-xv 
(Extracturn Colocynthidis Compositum) 

Containing colocynth, aloes, scammony and cardamon. 

Colocynthin (active principle) 0.005-0.01 gm. grs. ?\ i 
(Not official) 

PODOPHYLLUM 

Podophyllum is the underground root and rootlets of 
the Podophyllum peltatum, the May apple or mandrake, a 
perennial plant growing in Northern and Middle United 
States. 

Its active principles are two glucosides, podophylotoxin 
and picropodophylin. It also contains an alkaloid berberine. 

ACTION 

Local Action: On the skin it causes redness. 
On mucous membranes podophyllum causes pain, redness 
and profuse secretion of mucus. 

Internal Action 

In the mouth : It has a bitter pungent taste and increases 
the flow of saliva. 

In the stomach: It increases the secretion of gastric juice 
and the peristalsis of the muscle wall of the stomach, often 
therefore causing nausea and vomiting. 

In the intestines: Podophyllum acts principally on the 
duodenum or first part of the small intestine, increasing the 
secretions of its lining membrane, and markedly increasing 
the contractions of its muscle wall. 

The peristalsis of this part of the intestine also causes 
contractions of the bile ducts (which are attached to this 
part of the intestine), so that more bile passes into the 
intestines. 



INTESTINAL STIMULANTS 121 

Jalap therefore produces frequent copious fluid stools 
containing a great deal of bile, in about ten to fifteen hours 
after it is given. 

Podophyllum will also act as a drastic purgative if given 
hypodermically, or if it is absorbed from mucous membranes 
or the broken skin. This is probably due to the fact that it 
is excreted by the lining membrane of the intestines. 

Poisonous Effects 

In large doses, podophyllum causes violent and even 
dangerous symptoms. 

Abdominal pain, nausea, profuse vomiting and diarrhoea. 
The stools contain flakes of mucous membrane and blood. 

Associated with these symptoms, the patient presents 
the usual picture of collapse: cold moist skin, rapid thready 
weak pulse, slow and shallow breathing, dilated pupils. 
Finally the patient goes into coma, may have epileptic 
convulsions and die. 

Preparations 

Fluidextract of Podophyllum 0.3 -1.0 c.c. m. v-xv 

(Fluidextractum Podophylli) 

Resin of Podophyllum 0.015-0.06 gm. gr. J-i 

(Resina Podophylli) 

Pills of Podophyllum Belladonna and Capsicum 1 pill 
(Pilulae Podophylli Belladonnae et Capsici) 

Podophylin and Podophylotoxin 

(Unofficial) 0.005-0.01 gm. gr. T Vi 

GAMBOGE (GAMBOGIA) 

Gamboge is a gum resin obtained from the Garcinia 
hanburii, a tree of Siam. The leaves and young branches 
of the tree are broken off, and the juice is caught from the 
broken twigs in vessels and dried. This is the gum resin. 

Gamboge is used principally as a drastic purgative. 

It produces frequent large copious fluid stools accompanied 
by violent griping pains. Gamboge is one of the most violent 



122 MATERIA MEDICA 

drastic purgatives, and is usually given in small doses with 
other purgatives. 

Large doses of gamboge produce such violent catharsis 
and vomiting, with so much collapse, that death has occurred 
from these symptoms. 

Preparations 

Gamboge 0.1-0.6 gm. gr. ii-x 

(Gambogia) 

ELATERINE AND ELATERIUM 

Elaterium is the juice obtained from the fruit of Ecballium 
elaterium, or squirting cucumber, of Greece and Western 
Asia. This fruit contains an inner sac which is filled with 
juice and contains the seeds. The dried juice is elaterium, 
from which is obtained elaterin, the active principle which 
is the preparation used. It is a neutral crystalline substance. 

ACTION 

Local Action: Elaterine is decidedly harmful to the skin, 
causing destruction of the superficial layers. In those who 
handle this drug, it often causes ulcers and inflammation of 
the fingers. 

On mucous membranes it causes marked redness and 
swelling with profuse secretion of mucus. 

Internal Action 

In the stomach: Elaterine increases the secretion of the 
gastric juice and the contraction of the muscle wall, often 
causing nausea and vomiting. 

The intestines are the principal organs affected by elat- 
erine. It increases markedly the secretions of the lining 
membrane of the intestine and the peristalsis of its muscle 
wall. It also withdraws fluid from the blood and tissues 
into the intestines. 

The effect of all this activity is to cause frequent copious 
watery stools, with comparatively little griping, though the 
very frequent movements are very exhausting to the patient. 

Elaterine is one of the most effectual drastic purgatives. 



INTESTINAL STIMULANTS 



123 



It is often given hypodermically and probably produces its 
effect when given in this manner, by being excreted by the 
intestinal mucous membrane. 

It is used very frequently to remove fluid from the 
tissues in cases of dropsy (fluid in the tissues) and in ascites 
(fluid in the abdomen), and to reduce the blood pressure, by 
lessening the amount of blood, in cases of apoplexy. 

Poisonous Effects 

In large doses, elaterine causes violent vomiting and 
profuse diarrhoea with bloody stools, associated with such 
very severe collapse, that it may cause death. 

Preparations 

Elaterine 0.001-0.005 gm. gr. ^VrV 

(Elaterinum) 

Triturate of Elaterine 0.015-0.06 gm. gr. ^-i 

(Trituratio Elaterini) 

Containing 1 part of elaterine, to 9 parts of sugar of milk. 



COMPOUND PREPARATIONS OF DRASTIC PURGATIVES 

Compound Cathartic Pills 
(Pilulae Catharticae Compositae) 

This is very frequently used. Each pill consists of : 

Compound Extract of Colocynth 0.08 gm. gr. 1J 

Calomel 0.06 gm. gr. i 

Resin of Jalap 0.2 gm. gr. J 

Gamboge 0.015 gm. gr. \ 

1 pill is given as a purgative, 3 pills as a drastic. 

Vegetable Cathartic Pills 

(Pilulae Cartharticae Vegetabiles) 

Compound Extract of Colocynth 0.06 gm. 

Extract of Hyoscyamus 0.03 gm 

Resin of Jalap 0.02 gm 

Extract of Leptandra 0.015 gm 

Resin of Podophyllum 0.015 gm 



gr. i 
gr. i 
gr. i 
gr. i 
gr. i 



and about m. i of oil of peppermint for every hundred pills. 



124 MATERIA MEDICA 

The peppermint and the hyoscyamus (which contains 
an active principle atropine) lessen the griping. 



CROTON OIL (OLEUM TIGLH) 

Croton oil is a fixed oil (an oil which does not evaporate) 
pressed out from the seeds of the Croton tiglium, a shrub 
growing in Hindostan and other parts of Southern Asia. 

Its active principle is an acid crotonoleic acid. 

ACTION 

Local Action: On the skin croton oil causes redness with 
small elevated spots (papules). These soon form blisters 
which easily become infected and form pustules. 

Internal Action 

In the mouth it has a hot burning taste. 

In the stomach it often causes nausea, vomiting and pain 
in the abdomen. 

In the intestines: Croton oil acts principally on the in- 
testines; producing in one or two hours after it is given, 
frequent large fluid stools with severe griping pains. 

The violent movements of the bowels continue for about 
twelve to fifteen hours, and each stool is accompanied by 
severe griping, so that the patient soon becomes exhausted. 

Mode of Action 

Croton oil acts in the same manner as castor oil does. Cro- 
tonoleic acid is formed by the digestive juices, and this 
causes the purgative action. 

Some of the crotonoleic acid is then absorbed into the 
blood, and is excreted by all the secretions. 

Poisonous Effects 

In large doses, croton oil causes severe abdominal pain, 
nausea, vomiting, and profuse diarrhoea. The stools contain 
flakes of mucous membrane and blood. 

These symptoms are accompanied by very profound 



INTESTINAL STIMULANTS 125 

collapse: pale cold moist skin, slow and shallow breathing, 
rapid, weak thready pulse, and dilated pupils. The symp- 
toms may become so severe as to cause death. 

Preparations 

Croton Oil 0.06-0.12 c.c. m. i-ii 

(Oleum Tiglii) 

Administration 

Croton oil is given principally in cases where the patient 
is unable, or unwilling to swallow. In cases of apoplexy for 
instance, when the patient is unconscious; or in an attack of 
mania, when the patient is so excited, that he is unwilling to 
swallow medicine. 

In such cases one or two drops, either of the pure croton 
oil, or the oil dissolved in glycerin or olive oil, are given 
to the patient. It is also often given on a piece of sugar, or 
on a few bread crumbs. 

Croton oil is occasionally applied to the skin, to produce 
redness, and thereby relieve congestion of deeper organs, 
(counter irritant). A few drops of croton oil are poured 
on a piece of flannel, which is then rubbed on the skin. It 
may also be added to olive oil, or to a liniment, which is 
then rubbed on the skin. 

ENEMATA 

Enemata are fluids which are injected into the rectum. 
There are two kinds of enemata; cathartic and nutritive. 

Cathartic Enemata 

Cathartic enemata are given to move the bowels. They 
usually act by distending the large intestine, so that peris- 
talsis is set up, and the contents of the intestines are expelled 
and frequent movement of the bowels result. 

The substances which are commonly used in enemata are: 

Plain Water 

Salt Solution 

Soap Suds 

and various Cathartics. 



126 MATERIA MEDICA 

An excellent combination of cathartics which is given as 
an enema consists of ox gall, magnesium sulphate, turpentine 
and water. The turpentine is particularly valuable because 
it helps to expel gas. Another very excellent combination 
is one consisting of milk and molasses; or an enema con- 
taining starch. These substances are especially efficient, 
because the sugar or starch which they contain forms gas 
which distends the intestine very much, causing frequent 
copious movements of the bowels. 

Method of Administration 

An enema should be given by means of a fountain syringe, 
the patient lying on the back. The rubber nozzle is inserted 
into the rectum, the bag is held about three feet above the 
level of the patient, and the fluid is allowed to run into the 
rectum very slowly. 

In many cases, the enema is more effectual if the patient 
is placed in the knee chest position. 

Nutritive Enemata 

Nutritive enemata are usually given to nourish the pa- 
tient, when food cannot be taken by the mouth. They 
usually consist of milk, eggs, various meat juices, broths, 
or special prepared substances. They should preferably be 
peptonized. 

Administration 

Nutritive enemata should be given very slowly, best by 
the rectoclysis, or Murphy Method. 



PART n-STIMULANTS ACTING AFTER 
ABSORPTION 

CHAPTER VIII 

BLOOD AND CIKCULATORY STIMULANTS 

THE BLOOD 

The blood is a thick red fluid, which supplies all the vari- 
ous tissues and organs of the body with nourishment and 
oxygen. It also takes away all their waste products, result- 
ing from the various activities of these tissues and organs. 
These waste products are then brought to the lungs, kidneys 
and intestines where they are excreted. 

The blood consists of a straw colored fluid (plasma) in 
which float small round cells called corpuscles. 

There are two kinds of corpuscles: red corpuscles and 
white corpuscles, or leucocytes. 

The red corpuscles contain a substance haemoglobin, 
which contains iron, and gives these corpuscles their red color. 

The haemoglobin of the red corpuscles takes up oxygen 
from the air in the lungs; and brings it to the various organs 
of the body where it is used up by the various activities 
of these organs. 

The white corpuscles, together with the plasma, also act 
as cleansers of the blood. They destroy all bacteria in the 
blood and neutralize their poisons by the antidotes which 
they form. The white corpuscles then bring these dead 
bacteria to the kidneys, intestines and other organs for ex- 
cretion. These organs, by their secretions, get rid of the 
bacteria. 

Formation of Blood 

The plasma is formed from the digested food ; which then 
passes through the lining membrane of the intestines into 

127 



128 MATERIA MEDICA 

the blood vessels. Some of the digested food first enters 
the lymphatic vessels, and then into the blood. 

The red and white corpuscles of the blood are formed in 
the bone marrow and the spleen. 

The haemoglobin is formed in the liver and spleen. 

Drugs affect the blood in two ways: 

1. By increasing the amount, or improving the quality. 

Stimulation 

This can be done in several ways : 

a. They may increase the amount of plasma and the 
number of red or white corpuscles, or both. 

b. They may improve the quality of the corpuscles, for 
example, by increasing the amount of haemoglobin. 

2. They may lessen the amount, or deteriorate the quality 
of the corpuscles and plasma. 

Depression 

This effect is produced in several ways: 

a. They may lessen the amount of blood by taking away 
some of the fluids. 

b. They may reduce the number of corpuscles. 

c. They may combine with the haemoglobin so that it 
is unable to take up oxygen from the air in the lungs. 

We shall here consider only those substances which im- 
prove the condition of the blood (blood stimulants). 

HAEMATINICS (BLOOD STIMULANTS) 

These drugs are often called tonics. 

NORMAL SALT SOLUTION 

In cases where a patient has lost a considerable amount 
of blood, life may be endangered, because there is not a 
sufficient amount of blood for the heart to pump. The 
heart beats then become very weak and slow, and the pulse 
is weak, slow and soft. 

To keep the heart beating, until new blood can be formed, 
to make up for the amount that has been lost, we often 



BLOOD AND CIRCULATORY STIMULANTS 129 

inject into a vein, or into the muscles, salt solution of a 
definite percentage, to keep the heart beating; and thereby 
keep up the circulation of the blood. 

The percentage of salt (sodium chloride) used, is a 0.9% 
solution or 9 parts of salt to a thousand of water. Such 
a solution is called a normal salt solution. 

This strength of salt solution is used, because it does not 
destroy the red corpuscles of the blood. If a fluid weaker 
than this percentage is injected into the blood, the red 
corpuscles are destroyed. If a stronger percentage of salt 
solution than 0.9% is used, the blood corpuscles are shrunk 
(crenated). 

There are various strengths usually given for normal 
solution, varying from 0.6% to 0.9%. It is also often called 
physiological salt solution. 

The differences in the strengths are due to the fact that the 
blood contains other salts besides sodium chloride, such as 
calcium and magnesium sulphates and phosphates. 

The amount of sodium chloride in the blood is about 0.6%, 
while the percentage of all the salts in the blood amounts to 
about 0.9%. 

A salt solution containing the exact percentages of all 
the salts in the blood is often used in laboratories. This is 
called Ringer's solution. 

For practical purposes, however, normal salt solution 
contains 0.9% of sodium chloride, which is the percentage 
of all the salts in the blood. 

Such a salt solution is obtained by adding 5ii (8.0 gms.) 
of pure sodium chloride to a quart of sterile water. 

In making a normal salt solution, it is very important 
to use only absolutely sterile water; and pure sodium chlo- 
ride. 

Methods of Administration 

1. Intravenous Infusion: This is the quickest method for 
getting normal salt solution into blood. 

The solution is injected into the median basilic, or 
median cephalic veins of the forearm, by means of a special 
apparatus. 



130 MATERIA MEDICA 

The apparatus is held about two feet above the patient, 
and the salt solution is allowed to run through a long rubber 
tube and cannula; the cannula being inserted into the vein 
towards the heart. 

2. Hypodermoclysis: This is a slower method of getting 
normal salt solution into the blood. 

The solution is allowed to run in underneath the breasts, 
or into the thighs, through a large needle which is inserted 
in these regions, and which is attached to a rubber tube 
extending to a receptacle which contains the salt solution. 
The fluid is then absorbed into the blood from the tissues 
underneath the breasts, or from the thighs. 

3. Rectoclysis, or Murphy Method: A recent method of 
getting normal salt solution into the blood, is by allowing 
the solution to run into the rectum, drop by drop, through 
a catheter attached by a long rubber tube, to a receptacle 
containing salt solution, which is held a few feet above the 
level of the bed. The solution is then absorbed into the bood 
through the lining membrane of the rectum. 



Normal Salt Solution Should Always be Given Warm 

Effects 

After an intravenous infusion, or a hypodermoclysis of 
salt solution, the heart usually beats stronger and faster, 
the pulse is stronger, faster and more bounding in quality; 
and the blood pressure is very much increased. The patient 
breathes faster and deeper and feels brighter. 

Transfusion 

Occasionally when the patient has lost a great deal of 
blood; blood from another individual is allowed to run into 
the veins of the patient. This is done by sewing an artery of 
the healthy individual to the vein of the patient; and allow- 
ing the blood from the healthy individual to run into the 
patient, for about an hour. The effects produced are the 
same as when giving an infusion, but they are more 
lasting. 



BLOOD AND CIRCULATORY STIMULANTS 131 



IRON (FERRUM) 

Iron is a heavy metal; many of its preparations are used 
as drugs. Many food substances, such as meat, eggs and 
some vegetables, contain a great deal of iron. 

In the body, iron is found principally in the haemoglobin 
of the blood; about one part of iron to 230 parts of corpuscles. 

ACTION 

Local Action: On the skin iron causes no change, but if 
it is applied to a bleeding surface, it stops the bleeding, by 
precipitating (hardening) the albumins of the blood, which 
then close up the bleeding vessel. Mucous membranes are 
contracted by preparations of iron (astringent action). 

Internal Action 

In the mouth: Iron has a distinct metallic taste, and 
shrinks the lining membrane of the mouth, making it feel 
dry. It also blackens the teeth, if used continually. 

In the stomach : It also contracts the lining membrane and 
occasionally causes nausea. 

In the intestine: Iron contracts the lining membrane, 
checking the secretions, thereby producing constipation. 

Action after Absorption 

Part of the iron taken in as food, or as a medicine is 
slowly absorbed from the duodenum, or first part of the 
small intestine. It is then carried to the spleen, where it 
is stored up for future use; and to the liver, where it helps 
to form haemoglobin for the red blood corpuscles. If iron 
is taken for any length of time, more haemoglobin is there- 
fore formed; and the red blood corpuscles contain more 
haemoglobin. They are then better able to take up more 
oxygen from the air in the lungs. The corpuscles then 
supply the various organs and tissues of the body with 
more oxygen; so that these organs are able to do their work 
better. The corpuscles too, are also better able to take 
away more waste products. 

As a result of these effects, the heart beats stronger and 



132 MATERIA MEDICA 

faster; because its muscles are supplied with more oxygen. 
The patient is able to breathe deeper, and take in more air 
(and therefore more oxygen) because the muscles for breath- 
ing, such as the diaphragm, are supplied with more oxygen. 
The breathing center in the brain, also sends more impulses 
for breathing; because it too, is supplied with better nourish- 
ment. The food is digested better; because the stomach, 
the salivary and pancreatic glands secrete more digestive 
juices, as a result of being supplied with more nourishment 
and more oxygen. 

The muscles act better, because they, too, are supplied 
with better blood, containing more oxygen. 

The brain is more active, the patient is brighter, is more 
in harmony with his surroundings, because the brain is sup- 
plied with blood containing more oxygen. 

All the organs of excretion, such as the kidneys, the 
lungs and skin, get rid of waste products better and quicker, 
because these organs are supplied with better blood and 
are able to do their work better. 

Appearance of the Patient 

As a result of the improved activity of all the organs of 
the body, the patient feels brighter, is more active, more 
robust, he looks better, has a better color, his appetite is 
better, and he digests his food better. 

These effects do not come on after a few doses, but result 
from continued administration of iron. 

A drug which improves the general condition of the 
patient in this manner, is called a tonic. 

Excretion 

Only part of the iron taken as a medicine, or in the food, 
is absorbed. The rest is excreted by the intestines, in the 
stools. On account of the large amount of iron which is 
present in the stools, the lining membrane of the intestines 
is contracted, and constipation results. 

Uses 

Iron is used principally in Gases of anaemia; a condition 
where the patient's blood is very poor; for example — when 



BLOOD AND CIRCULATORY STIMULANTS 133 

the patient has lost a great deal of blood, or when he is suf- 
fering from some chronic disease, such as tuberculosis or 
cancer. It is also used with best results in a peculiar kind 
of anaemia, occurring in young girls, called chlorosis. 

Poisonous Effects 

In some cases, after continued use of iron for any length 
of time, it produces the following symptoms. Frontal head- 
ache, loss of appetite, pain in the pit of the stomach, occa- 
sionally nausea and vomiting, colic and invariably constipa- 
tion. Sometimes the skin becomes covered with very small 
pustules (acne). 

The condition is relieved by stopping the iron, and giving 
cathartics. 

Administration 

In giving iron, the nurse should carry out the following 
rules: 

1. Iron should always be given well diluted, after meals. 

2. To avoid blackening the teeth, it should always be 
given through a glass tube, so that it does not touch the 
teeth. 

3. To avoid constipation, whenever iron is given, the 
bowels should be moved regularly with some cathartic, or a 
preparation of iron should be given which contains a cathar- 
tic. 

4. If a gargle containing iron is used, the teeth should be 
brushed after each application, and the mouth then gargled 
with salt water. 

5. Silver spoons are stained by iron and they should 
never be used in giving iron. Strong ammonia water removes 
these stains. 

6. Iron also stains clothing, sheets, carpets, etc. Oxalic 
acid removes these stains. 

Preparations 

The preparations of iron are very numerous and only the 
most important ones are here given. 



134 MATERIA MEDICA 

There are several preparations of iron which are only 
used for their local effects or to check bleeding. 
For internal use there are two kinds of preparations. 

Inorganic and Organic 

The inorganic preparations are metallic salts of iron. 

The organic preparations are preparations of iron com- 
bined with various kinds of proteids, such as egg albumin 
for instance. 

The organic preparations do not contract mucous mem- 
branes as much as the inorganic ones, and are therefore not 
so apt to cause unpleasant symptoms. 

Preparations for Local Use 

Solution of Iron Subsulphate 0.2-0.6 c.c. m. ii-x 

(Liquor Ferri Subsulphatis) 
(Monsell's solution) 

This preparation contains about 13% of iron. 

Iron Chloride 
(Ferri Chloridum) 

This preparation is used either in a 20% solution, or the 
pure crystals are allowed to take up moisture from the air 
by being exposed (deliquescent action), and are then used. 

These two preparations are principally used locally, to 
stop bleeding or to contract mucous membranes, either by a 
local application, or given as a gargle. 

Iron Sulphate 0.03-0.3 gm. grs. {-v 

(Ferri Sulphas) 
(Green vitriol) 

This is seldom used internally, but it is used to contract 
mucous membranes and check bleeding. It is also used as a 
disinfectant for privies or drains. 

Preparations for Internal Use 
Inorganic Preparations 
Solid Preparations: 

Pills of Iron Carbonate 1-5 pills 

(Pilulae Ferri Carbonatis) 
(Blaud's pills) 



BLOOD ANiTITlRCULATORY STIMULANTS 135 

These pills consist of iron sulphate, the carbonate of 
sodium or potassium, tragacanth, sugar and glycerin. 

Each pill contains about 0.06 gm. (gr. i) of iron. 

These pills must be made up fresh, as otherwise they 
pass through the intestines without causing any effects, 
or without being themselves changed in any way. 

Reduced Iron 0.06-0.12 gm. grs. i-ii 

(Ferri Reductum) 

(Quevenne's Iron) 

This is a brown powder which is tasteless and does not 
contract mucous membranes. It is often given to children 
in candy. 

Soluble Iron Phosphate 0.06-0.3 gm. grs. i-v 

(Ferri Phosphas Solubilis) 

Iron Citrate 0.06-0.3 gm. grs. i-v 

(Ferri Citras) 

Pills of Iron Iodide 1-3 pills 

(Pilulae Ferri Iodidi) 

Each pill contains 0.03 gm. (gr. |) of reduced iron, also 
iodine, acacia, licorice and balsam of tolu. 

Iron and Strychnine Citrate 0.1-0.3 gm. grs. ii-v 

(Ferri et Strychninae Citras) 

Contains 1% of strychnine and 16% of iron. 

Iron and Quinine Citrate 0.3-0.6 gm. grs. v-x 

(Ferri et Quininae Citras) 

Contains 12% of quinine and 15% of iron. 

Solid Preparations Combined with Cathartics 

Iron and Potassium Tartarate 0.3-0.6 gm. grs. v-x 
(Ferri et Potassii Tartaras) 

Contains 15% of iron. 

Pills of Aloes and Iron 0.2-0.5 gm. grs. iii-viii 

(Pilulae Aloes et Ferri) 

It contains dried iron sulphate and aloes. The aloes 
overcomes the constipating effect. It is often used in 



136 MATERIA MEftftfeno./ 

cases of scanty menstruation or absence of menstruation 
(amenorrhoea), in chlorosis. 



Fluid Preparations 

Solution of Iron Tersulphate 
(Liquor Ferri Tersulphatis) 

Contains 10% of iron. 

This preparation is only used to make other preparations, 
especially the antidote for arsenic. 

Tincture of Iron Chloride 0.3-2.0 c.c. m. v-xxx 

(Tinctura Ferri Chloridi) 

(Muriated tincture of iron) 

This is one of the best preparations of iron, and is very 
frequently used. It contains about 4% of iron in alcohol. 

It is best given in milk or in glycerin, 3 parts of the prep- 
aration to one of glycerin, (to prevent constipation) or in 
egg albumin, to prevent its blackening the teeth. 

Solution of Iron and Ammonium 

Acetate 15.0-30.0 c.c. 3i~ i 

(Liquor Ferri et Ammonii Acetatis) 

(Basham's mixture) 

This preparation contains very little iron and must be 
freshly made. It consists of the tincture of iron chloride, 
dilute acetic acid, solution of ammonium acetate, elixir 
of orange, glycerin and water. 

Syrup of Iodide of Iron 0.3-2.0 c.c. m. v-xxx 

(Syrupus Ferri lodidi) well diluted 

This is an excellent preparation especially for children. 
It contains about 2% of iron. 

Compound Iron Mixture 15.0-30.0 c.c. S^-i 

(Mistura Ferri Composita) 

(Griffith's mixture) 

This preparation contains iron sulphate, potassium car- 
bonate, myrrh, sugar and spirits of lavender. 



BLOOD AND CIRCULATORY STIMULANTS 137 

Elixir of Iron Quinine and Strychnine Phosphate 
(Elixir Ferri, Quininae, et Strychninae Phosphatum) 

This preparation is very frequently used as a tonic. It 
contains about 2% of iron phosphate. 

Each teaspoonful dose contains \ grain of iron phosphate 
and quinine and ^ grain of strychnine. 

Syrup of Iron, Quinine and Strychnine Phosphate 
(Syrupus Ferri Quininae et Strychninae Phosphatum) 

4.0-8.0 c.c. 5i-ii 

This preparation contains 9% of iron phosphate. Each 
teaspoonful dose, contains grs. v of iron phosphate, -| grain 
strychnine and H grain of quinine. 



Antidotes for Arsenic 



Iron Hydroxide 
(Ferri Hydroxidum) 



This preparation is used principally as an antidote for 
arsenic poisoning. About 8 grains of it will neutralize 1 grain 
of arsenic. It must always be fresh. 

If it is not on hand, it can be made from the tincture of 
iron chloride, by adding ammonia water or sodium car- 
bonate to it. A precipitate (sediment) will then form. 

Enough ammonia or sodium carbonate must be added 
until no more sediment forms. 

The sediment is then washed and strained, and given in 
milk, as often as is necessary to neutralize the arsenic. 

Iron Hydroxide with Magnesia Oxide 15.0-30.0 gms. l|-i§ 
(Ferri Hydroxidum cum Magnesii Oxido) 

This is made from iron sulphate, to which is added mag- 
nesia. It is the best antidote for arsenic poisoning. 

Dialyzed Iron (not official) 1.3-2.6 c.c. m. xx-xl 

(Ferri Dialysatum) 

This is a preparation of iron which is frequently used as 
an antidote for arsenic poisoning. It is also used in the 
treatment of anaemia. 



138 MATERIA MEDICA 



ORGANIC PREPARATIONS 



These preparations of iron are made with organic sub- 
stances such as proteids; (albumins, peptones, etc.). They 
have no advantage over the other preparations of iron, ex- 
cept that they are more readily absorbed, and do not con- 
tract mucous membranes as much as the inorganic prepara- 
tions. Most of them are not official. 

Solid Preparations 
Iron Tropon (not official) 4.0-8.0 gms. 3i-ii 

This is a preparation of iron with proteids, flavored with 
chocolate. It comes in powder form or in tablets. The 
powder is given in milk. 

Haemogallol (not official) 0.25-0.5 gm. grs. iv-viii 

This is an organic iron preparation made from blood. 

Ferratin (not official) 0.5 gm. grs. vii| 

This substance is made from egg albumin and iron. 

Ferrous Lactate 0.06-1.2 gm. grs. i-xx 

(Not official) 

It is best given in syrup. 

Fluid Preparations 

Ferro Mangan 4.0-16.0 c.c. 5H$i 

(Not official) 

This is a solution of iron, manganese and peptones. 
There are several other similar preparations under various 
names, such as peptomanganate of iron, etc. 

Ovoferrin 8.0-16.0 c.c. 5ii-iv 

(Not official) 

This is a preparation made from serum albumin and iron 
by an electrical process. 

Haemaboloids 15.0 c.c. S| 

(Not official) 

This is a compound of iron, proteids and bone marrow. 



BLOOD AND CIRCULATORY STIMULANTS 139 

Incompatibilities 

The following drugs cannot be given together with iron 
as they form chemical compounds with it. 

The preparations of iron should never be given with tea, 
or vegetable drugs containing tannin or tannic acid, as iron 
combines with these drugs and forms ink. 

The alkaline preparations of iron should not be given 
with acids. For example — do not give Basham's mixture 
together with dilute acids, as they combine and form a 
sediment. The iron salts of the mineral acids should not be 
given with alkalies. For example — do not give tincture of 
iron chloride with sodium bicarbonate, as they will combine 
and form a sediment. 

The most efficient and most frequently used preparations 
of iron are 

Blaud's Pills 

Tincture of Iron Chloride 
Syrup of Iodide of Iron 
Basham's Mixture 

and a number of the organic preparations. 

MANGANESE (MANGANUM) 

Manganese is a metal. Many of its preparations are 
occasionally used in medicine. 

It is found in the body in the red blood corpuscles, the 
hair and bile, usually together with iron. 

Some of its preparations, especially potassium perman- 
ganate, is used as an antiseptic. 

ACTION 

Local Action: On the skin and mucous membranes, man- 
ganese contracts the tissues (astringent action). 

Internal Action 

In the mouth it contracts the mucous membranes. 
In the stomach it increases the secretion of gastric juice, 
aids digestion and increases the appetite. 

In the intestines it contracts the mucous membrane. 



140 MATERIA MEDICA 

Action after Absorption 

Manganese is partly absorbed in the intestine, and after 
absorption, it is said to act like iron, increasing the nutrition 
of the various organs and tissues of the body. 

It is occasionally used as a substitute for iron. It cannot 
replace it, however, as it does not help to form haemo- 
globin. 

It is said to increase menstruation. 

It is excreted by the intestine and kidneys. 

Poisonous Effects 

Large doses of manganese cause nausea, vomiting and 
profuse diarrhoea, slow and very soft pulse with very low 
blood pressure, slow breathing and stupor. 

If large doses of manganese are given for some time, it 
causes weakness, weak pulse, staggering gait and paralysis. 

Preparations 

Precipitated Manganese Dioxide 0.25 gm. grs. iv 

(Mangani Dioxidum Praecipitatum) 

Manganese Sulphate 0.1-0.5 gm. grs. ii-viii 

(Mangani Sulphas) 

Manganese Hypophosphate 0.2 gm. grs. iii 

(Mangani Hypophosphis) 

Potassium Permanganate 0.03-0.15 gm. gr. -J — iii 

(Potassii Permanganas) 

This preparation gives off oxygen, and for this purpose, 
it is often given in cases of poisoning from various drugs. 
For example — in morphine poisoning it is given to neutralize 
the morphine by the oxygen which the potassium perman- 
ganate liberates, which then combines with the drug. 

It is also used as an antiseptic, acting in a similar manner, 
the oxygen destroying the bacteria. 

There are a number of unofficial preparations of iron 
which are combined with manganese. 



BLOOD AND CIRCULATORY STIMULANTS 141 



ARSENIC 

Arsenic is a metal which is commonly used in the manu- 
facture of dyes and other commercial products. 

It is one of the oldest drugs in medicine, and was very 
frequently used during mediaeval times for criminal poison- 
ing. There are a number of compounds of arsenic, but only 
one group of them is used in medicine. These are the com- 
pounds of arsenic trioxide, white arsenic or arsenious acicL 

Appearance of the Patient 

When small doses of arsenic are given for some time, 
the patient feels better, stronger and is more active. He 
looks more robust, somewhat stouter and has a better color. 
The appetite is better and the bowels move more often. 
The pulse is stronger, somewhat faster and the patient 
breathes somewhat deeper. In short, the patient feels 
better and stronger. 

ACTION 

Local Action: Arsenic applied to the skin causes inflamma- 
tion and pain. If it is allowed to remain on the skin for a 
longer time, the skin is destroyed and an ulcer remains. 
(Escharotic action.) Arsenic is slightly antiseptic. 

It is easily absorbed from the injured skin. On mucous 
membranes when applied locally, it also causes redness and 
pain, with subsequent inflammation and destruction of the 
tissues. 

Internal Action 

In the mouth arsenic has a sweetish taste, causes redness 
of the lining membrane of the mouth and increases the flow 
of saliva. 

Arsenic affects principally the stomach and intestines 

In the stomach it causes a sense of heat, it increases the 
appetite and the secretion of gastric juice. 

In the intestines it also increases the secretion of the 



142 MATERIA MEDICA 

mucous membrane of the intestines, and it also increases the 
peristalsis, so that the bowels move more actively and more 
often. 

Action after Absorption 

Arsenic is rapidly absorbed from the stomach and intes- 
tines, as well as from all the mucous membranes. After ab- 
sorption, it affects principally the blood and the tissues. 

Action on the Blood: Arsenic increases the number of red 
blood corpuscles. It increases the formation of these cor- 
puscles in the bone marrow. 

Since there are more red blood corpuscles in the blood, 
they are able to carry more nourishment and more oxygen 
to the organs and tissues of the body, and remove more 
waste products. 

In this way, they increase the activity of all the organs 
of the body in the same way as iron does. 

The patient is then healthier, more robust, has a better 
appetite and feels better (tonic action). 

Action on the Tissues: Arsenic prevents the tissues from 
being used up (lessens oxidation). It therefore increases 
the growth and nutrition of the tissues and organs of the 
body. As a result of this action, if arsenic is taken for some 
time, the patient usually becomes somewhat stouter. 

Action on the Circulation: In the doses that arsenic is 
usually given, it makes the heart beat stronger, though the 
rate of the pulse is not much affected. The pulse is therefore 
usually much stronger. 

Action on the Respiration : The breathing is usually deeper 
and faster, the patient takes in more air, and therefore more 
oxygen for the greater number of corpuscles which the 
blood contains. 

Action on the Brain and Spinal Cord: The brain and 
spinal cord are more active, when arsenic is given for some 
time. The effects of this increased activity, are shown by 
the following condition of the patient. 

He is more active, brighter, he sees and hears better. 
He responds quicker and better to sensations (increased 
reflex action). 



BLOOD AND CIRCULATORY STIMULANTS 143 

Excretion 

Arsenic is excreted mainly by the urine, also by the lining 
membrane of the stomach, intestines and bronchi. 

It is excreted very slowly and may therefore cause cumula- 
lative symptoms. 

Tolerance 

When arsenic is taken regularly in small quantities, the 
patients are then able to take comparatively large quanti- 
ties of the drug without getting poisonous effects. A patient 
is then said to have a tolerance for arsenic. 

In some countries, for example in the Tyrol, the peasants 
eat large quantities of arsenic, because it enables them to do 
their work better, and to climb the mountains with less 
effort. It also improves their complexion. These peasants 
often live to a very old age. 

Women very often take arsenic for a long time to improve 
their complexion and their figure. Some of them often get 
poisonous symptoms as a result of it. 

Uses 

Arsenic is used principally in anaemia, to improve the 
condition of the blood. It is often given together with iron. 

It is also given for chorea (St. Vitus' dance), and as a 
tonic, to improve the general condition of the patient. 
Some of the newer preparations of arsenic are given as a 
specific for syphilis. 

Poisonous Effects 

There are two forms of arsenic poisoning. 

1. Acute arsenic poisoning. 

2. Chronic arsenic poisoning. 

Acute Arsenic Poisoning 

This follows a single large dose of arsenic taken with 
suicidal intent or by mistake. 

Many rat and insect poisons, contain large quantities of 
arsenic. 



144 MATERIA MEDICA 

There are two forms of acute arsenic poisoning. 

a. Cases where the symptoms of the stomach and intes- 
tines are most marked. These cases are the most common 
and this form of poisoning is called the gastero intestinal 
form. 

b. Cases where the nervous symptoms are most marked. 
These cases are called the nervous form. 

Gastero Intestinal Form 

About one-quarter of an hour to an hour after an overdose 
of arsenic is taken, the patient complains of severe pains in 
the oesophagus and stomach, and of a metallic taste in the 
mouth. The pains spread all over the abdomen and are 
accompanied by profuse vomiting and diarrhoea. The vomited 
matter contains bile, later serum and even blood, with 
small flakes of the lining membrane of the stomach float- 
ing about in the fluid. The stools are very fluid and contain 
many flakes of mucous membrane and blood. 

As a result of the excessive vomiting and diarrhoea, the 
patient is very thirsty, passes very little urine, and whatever 
urine is passed contains blood and is passed with severe pain. 

The collapse following these symptoms is very severe, 
the patient looks very pale, his skin is cold and covered with 
perspiration, later he looks very blue. The breathing is 
rapid, difficult and painful, because of the severe abdominal 
pain. The pulse is rapid, intermittent and weak. The 
pupils are widely dilated. 

Finally the patient goes into coma, may have convulsions 
and die in from five to twenty-four hours. If the dose has 
not been very large, the patient may live longer, even for a 
few days or weeks and then die of exhaustion or nervous 
complications. During these symptoms the patient is con- 
scious to the very last. 

Nervous Form 

In some cases the patient has little or no symptoms from 
the stomach and intestines (abdominal pain, vomiting 
diarrhoea, etc.) ; but instead, he goes into coma, has all the 
symptoms of collapse, has several convulsions and dies. 



BLOOD AND CIRCULATORY STIMULANTS 145 

If the patient recovers from the acute symptoms, there 
may remain various nervous symptoms, such as, areas of 
numbness on the extremities, loss of sensation to heat and cold, 
and paralysis of the extremities, resulting in "drop hands' 7 
and "drop feet." The patient usually recovers from these 
symptoms however. 

The smallest fatal dose of arsenic is 0.12 gm. (grs. ii). 

Treatment of Arsenic Poisoning 

In treating arsenic poisoning the following points must 
be considered. 

1. The arsenic should be neutralized by giving an anti- 
dote. 

The best antidotes for arsenic, are 

Iron Hydroxide. 

Iron Hydroxide with magnesia oxide. 
These should be given until no more symptoms of arsenic 
occur. 

2. Produce vomiting, by giving an emetic, such as mus- 
tard water, salt water, zinc sulphate or copper sulphate, or 
better still, wash out the stomach. 

3. Protect the lining membrane of the stomach and intes- 
tines; by giving plenty of drinks of substances which pro- 
tect the mucous membrane, such as albumin water, flaxseed 
water, gelatine, etc. 

4. Give plenty of water* to increase the flow of urine, 
and thereby get rid of most of the arsenic, and to allay the 
thirst. Give cathartics to remove the poisons from the 
bowels. 

5. The severe collapse, which may cause the death of 
the patient, should be treated by: 

a. Hot applications to the skin, and plenty of coverings 
to keep the patient warm. 

b. Drugs to increase the heart action and the breathing. 
The best ones are: 

Caffeine 

Atropine 

Strychnine 

Digitalis preparations (those that are rapidly absorbed). 



146 MATERIA MEDICA 

Chronic Arsenic Poisoning 

Chronic arsenic poisoning is very common. It occurs after 
giving arsenic preparations for some time; and since arsenic 
is excreted much slower than it is absorbed, cumulative 
symptoms, or chronic arsenic poisoning results. 

It also results from inhaling fumes of arsenic, in rooms 
papered with wall paper containing arsenic dyes, by wearing 
clothing dyed with arsenic, or by eating food colored with 
arsenic dyes. The following symptoms in the order of their 
onset are noticed after prolonged administration. Often the 
later symptoms appear before the earlier ones. 

Symptoms 

1. Itching of the eyelids. 

2. Redness of the conjunctiva of the eye. 

3. Puffiness about the eyes, especially in the morning. 

4. Sneezing, " running nose' ' (coryza). 

5. Tightness in the throat. 

6. Hoarseness. 

7. Loss of appetite, heaviness in the stomach, nausea 
and vomiting. 

8. Skin eruptions; red spots, areas of brownish discolora- 
tion (very often they look like freckles) on the face or the 
abdomen. Dark discolorations which look like pencil marks 
on the skin of the abdomen. 

In severe cases, the hair and nails may fall off. 

9. Cramp-like abdominal pains. 

10. Diarrhoea with "rice water" stools. These are fluid 
stools which contain small flakes of the lining membrane of 
the intestine. 

The following symptoms appear later and only in severe 
cases: 

11. Persistent headache. 

12. Pains around the knee, ankle, foot and hands. 

13. Redness and swelling of the hands and feet. 

14. Areas of skin which are very sensitive to touch, to pain, 
to heat and cold. These occur especially on the extremities. 

15. In severe cases there are paralyses of the extensor 



BLOOD AND CIRCULATORY STIMULANTS 147 

muscles of the hands and feet, resulting in "drop feet" and 
"drop hands." 

Treatment of Chronic Arsenic Poisoning 

If the arsenic is stopped and cathartics given, the symp- 
toms usually disappear gradually. The paralyses must be 
treated by massage and electricity, until the muscles recover; 
which they usually do. 

Preparations 

Fluid Preparations: 
Solution of Potassium Arsenite 0.06-0.5 c.c. m. i-viii 
(Liquor Potassii Arsenitis) 
(Fowler's solution) 

This contains 1% of arsenic trioxide, potassium bicar- 
bonate and tincture of lavender. 

Five minims of Fowler's solution contain A gr. of arsenic 
trioxide. 

Solution of Sodium Arsenite 0.06-0.5 c.c. m. i-viii 

(Liquor Sodii Arsenitis) 
(Pearson's solution) 

Solution of Arsenious Acid 0.06-0.5 c.c. m. i-viii 

(Liquor Acidi Arsenosi) 

This contains 1% of arsenic trioxide and dilute hydro- 
chloric acid. 

Solution of Arsenious and Mercuric 

Iodides 0.3-1.2 c.c. m. v-xx 

(Liquor Arseni et Hydrargyri Iodidi) 

(Donovan's solution) 

This is the strongest preparation of all. It contains 1% 
each of arsenic iodide, and of red mercuric iodide. It may 
cause symptoms of mercury poisoning. 

Solid Preparations : 
Arsenic Trioxide 0.001-0.005 gm. gr. tjVtt 

(Arsenii Trioxidum) 

Sodium Arsenate 0.001-0.005 gm. gr. inr-iV 

(Sodii Arsenas) 



148 MATERIA MEDICA 

Arsenic Iodide 0.003-0.01 gm. gr. -fa-} 

(Arsenii Iodidum) 

Sodium Cacodylate 0.015-0.06 gm. gr. J-i 

(Sodii Cacodylas) 

This is a compound of cacodylic acid, which is a com- 
pound of arsenic. It is given hypodermically and is said to 
cause no unpleasant symptoms. 

Arsen Triferrin 0.3 gm. grs. v 

(unofficial) 
This a compound of iron, arsenic, phosphorus and albumin. 

Soamin (not official) 

This is sodium arsanilate, and contains 22% of arsenic. 
It usually comes in tablets each containing 0.06 and 0.3 gm. 
(grs. i-v) of soamin. 

Salvarsan " 606 " 0.3-0.6 gm. grs. v-x 

Neosalvarsan " 914 w 0.3-0.6 gm. grs. v-x 

These are organic compounds of arsenic which are used 
as specifics for syphilis. They are given intravenously, 
like an intravenous infusion, or they are injected deep into 
the muscles. Salvarsan has to be neutralized very carefully 
with an alkali. Both of these preparations come in closed 
glass tubes containing nitrogen gas and the powder. 

Atoxyl 

This is Sodium Arsanilate, and comes in tablets of 0.02 gm. 
(gr. J) for hypodermic use. 

Administration 

Arsenic preparations should be given well diluted after 
meals. 



CARDIAC STIMULANTS 

The Circulation of the Blood 

The blood supplies all the organs and tissues of the body 
with nourishment, and takes away their waste products. 
It reaches these organs and tissues, by being pumped by 
means of a complicated pump, the heart, to the various organs 
and tissues of the body along numerous small tubes which 
gradually grow smaller; the arteries. 

The impure blood is then carried back to the heart from 
the tissues and organs, by means of a system of tubing called 
the veins. 

The Heart 

The heart is a pear-shaped organ, about the size of one's 
fist, situated in the left side of the chest. It consists of four 
chambers. Two of these chambers receive blood into the 
heart from the veins, and are called Auricles, and two of 
them send blood out to the organs and tissues of the body, 
and are called Ventricles, 

The right auricle receives impure blood (blood containing 
waste products) from the various organs and tissues of the 
body. This impure blood is then pumped into the next 
chamber, which is the right ventricle. From the right ven- 
tricle this impure blood is pumped into a large artery, the 
pulmonary artery, to the lungs. Here some of the waste 
products of the blood are excreted, and instead, the red cor- 
puscles take up oxygen from the air in the lungs. 

This purified blood is then carried back along the pulmo- 
nary veins, to the left auricle, and from there it is pumped 
into the left ventricle. The left ventricle then pumps the 
blood into the large arteries; the aorta and its branches. 
The blood then passes through these arteries and their 
branches, to the various organs and tissues of the body, 
which are thus supplied with oxygen and nourishment. 
It then takes away the waste products from these tissues 
and organs, and brings them back again to the heart, and 

149 



150 MATERIA MEDICA 

then to the lungs, where they are excreted, and new oxygen 
obtained. 



The passage of the blood, to the various parts of the body from 
the heart along the arteries, and then back again to the heart 
along the veins, is called the circulation of the blood. 

The blood is kept circulating by the regular contractions 
of the heart, which in normal healthy individuals, occur 
about 72 times a minute. 

Each contraction consists of two parts or phases. 

1. The period of contraction, which is the time when the 
heart becomes smaller and expels its contents; the blood. 
This is called the systole of the heart. 

2. The period of relaxation, which is the time when the 
heart becomes larger, and contains a greater amount of blood. 
This is called the diastole of the heart. 

The heart contracts because of an intrinsic power of the 
heart muscle. This can be proven by the fact that the heart 
of an animal will contract for a little while, even when it is 
taken out of the body. 

The contractions of the heart, however, can be affected 
by the following influences. 

1. By impulses coming from the medulla of the brain 
along special nerves going to the heart called the accelerator 
nerves. 

The impulses traveling along these nerves, cause the heart 
to beat stronger and faster. As a result of these impulses, 
the contractions or systoles are stronger, greater and more 
frequent; while the relaxation or diastoles of the heart are 
diminished. 

2. By impulses coming from the medulla of the brain 
along special nerves going to the heart called the Vagus, 
Pneumogastric or inhibitory nerves. These impulses make 
the heart beat slower and weaker. As a result of these 
impulses, the relaxation period or diastoles, are greater 
and last longer. The contractions or systoles, therefore 
occur less frequently because the relaxation of the heart or 
diastole, takes up so much time. 



BLOOD AND CIRCULATORY STIMULANTS 151 

3. The width of the blood vessels, especially the very small 
blood vessels, also influences the contractions of the heart. 

When the blood vessels are narrow, the heart must beat 
stronger and faster, in order to pump the blood through nar- 
rower blood vessels; because the narrower the vessels are, 
the greater resistance do they offer to the contractions of the 
heart. 

When the blood vessels are wider, the heart does not have 
to contract so forcibly to propel the blood through the blood 
vessels, because they offer no resistance to the flow of blood. 

The width of the blood vessels is regulated by small mus- 
cle fibers in their walls. The contractions of these muscle 
fibers, makes the blood vessels narrower; and, by their re- 
laxation, they make the blood vessels wider. 

There are also impulses which are sent down from a spot 
of gray matter in the medulla of the brain (the vaso motor 
center), which cause these muscle fibers to either contract, or 
relax, and thereby regulate the size of the blood vessels. 

Effects of Drugs on the Heart 

Drugs affect the heart in two ways : 

1. They increase its activity (stimulation). 

2. They diminish its activity (depression). 

Stimulation of the Heart 

When drugs increase the activity of the heart, or stimulate 
it, they make the heart beat stronger and faster. The con- 
tractions or systoles of the heart are stronger, while the 
period of relaxation or diastole is lessened. 

When the heart beats stronger and faster, the pulse is 
usually stronger and faster; because the character of the 
pulse depends largely on the contractions of the heart. 

This increased activity of the heart is produced in several 
ways. 

a. By acting directly on the heart muscle to make it con- 
tract more forcibly and more frequently. 

b. By causing more impulses to be sent out from the 
medulla of the brain along the accelerator nerves which 
then make the heart beat stronger and faster. 



152 MATERIA MEDICA 

c. By paralyzing the nerve endings in the heart of the 
Vagus or inhibitory nerves, so that all impulses which slow 
the heart, are cut off; and do not reach it. The heart then 
beats stronger and faster; the systoles or contractions are 
increased, while the diastoles or relaxations are diminished. 

d. By contracting the small muscle fibers in the walls of 
the small blood vessels, the contractions of the heart are 
increased in strength and frequency, to overcome the in- 
creased resistance which the narrower blood vessels produce. 

Many drugs increase the heart action in one or a number 
of these ways. Some drugs may increase the strength of the 
contractions though they may lessen their frequency. 

This is often a very beneficial effect; because the individual 
contractions are stronger and the circulation of the blood 
is therefore better. The slow contractions of the heart, 
however, prevent the heart from becoming exhausted from 
overwork. For example, digitalis, which is an excellent 
heart stimulant, causes strong contractions of the heart, 
though the heart beats slower. 

Depression of the Heart 

When drugs diminish the activity of the heart, or depress 
it, the heart beats slower and weaker. The contractions or 
systoles are lessened, while the period of relaxation or 
diastoles, are increased. The heart therefore beats slower 
and weaker. The pulse is therefore slower and weaker. 

This action is produced in several ways. 

a. By directly affecting the heart muscle so that the heart 
beats slower and the contractions are weaker. 

b. By sending impulses from the medulla of the brain 
along the Vagus or inhibitory nerves to cause the heart to 
beat slower and weaker. This effect can also be produced 
by increasing the action of the nerve endings of the Vagus 
nerve in the heart; so that they will be more susceptible to 
receive such impulses. 

c. By paralyzing the nerve endings in the heart of the 
accelerator nerves. The impulses for increasing the heart 
action are thus cut off; and the heart will then beat slower 
and weaker. 



BLOOD AND CIRCULATORY STIMULANTS 153 

d. By causing the small muscle fibers in the walls of the 
blood vessels to relax, thereby widening these vessels. The 
heart will then have to contract less actively and slower. 

Effects of Overdoses 

In overdoses, the effects of either a heart stimulant or a 
depressant may be the same. For example, when the heart 
action is increased, the heart beats strong and fast, but when 
it is overacting and is exhausted, it may beat very slow and 
weak. In poisonous doses then, a heart stimulant may cause 
symptoms of depression. 

A drug which lessens heart action, however, or a de- 
pressant, makes the heart beat slow and weak. In overdoses 
the heart will then beat even slower and still weaker. 

HEART STIMULANTS 
CAFFEINE (CAFFEINA) 

Caffeine is a white crystalline powder, an alkaloid; the 
active principle of the coffee bean, Coffea arabica: of tea 
leaves, thea chinensis of China; Paraguay tea of Argentine; 
the kola nut of Central Africa and the guarana paste of Brazil. 

Coffee was originally used by the Arabians; but it is now 
a universal beverage. The same effects can be obtained 
from coffee, as from caffeine; for the action of coffee is due 
principally to the caffeine which it contains. 

Coffee and tea are very common beverages. They are 
infusions of the coffee bean or tea leaves. The coffee bean 
contains about f % of caffeine. A cup of coffee contains 
about 0.1-0.2 gm. (grs. li to iii) of caffeine. 

Coffee has a laxative effect because of volatile oils which 
it contains. 

Tea contains about 1\ to 2% of caffeine. A cup of tea 
also contains 0.1-0.2 gm. (grs. H to iii) of caffeine. This 
is due to the fact that less tea is used in making tea. 

Tea contains a large amount of tannic acid, however, which 
makes it contract mucous membranes (astringent action). 

Appearance of the Patient 
When a patient is given an average dose of caffeine, or 



154 MATERIA MEDICA 

when a strong cup of coffee is taken, the following effects 
are noticed. 

The patient is more wakeful, brighter, and is able to think 
quicker and better; and to reason better. In fact, all mental 
work can be done better and with less fatigue. The patient 
is more active and responds more easily, more rapidly and 
better, to all influences about him. The pulse is quicker 
and stronger; and the breathing is deeper and more frequent. 
The patient also urinates more frequently and passes more 
urine. 

Caffeine is an ideal stimulant; because it increases the 
activity of almost every organ of the body. Its effects come 
on in about a half to one hour after it is given, and last only 
for one or two hours. 

ACTION 

Caffeine produces no effects when applied locally on either 
the skin or mucous membranes. 

Internal Action 

In the mouth : Caffeine has a slightly bitter taste. 

In the stomach: It produces no effects; but it is absorbed 
into the blood through the lining membrane of the stomach 
in about half to one hour after it is taken. 

In the intestines: Caffeine produces no effects. Coffee, 
however, because of a number of volatile oils which it con- 
tains, increases the peristalsis; causing mild movements of 
the bowels. 

Action after Absorption 

After it is absorbed into the blood, caffeine affects prin- 
cipally the heart, the blood vessels, the respiration, the 
muscles, the brain and the kidneys. The effects it produces 
last only for about one to two hours. 

Action on the Heart: After ordinary doses of caffeine are 
given, the heart beats stronger and faster. This is due to 
the caffeine acting directly on the heart muscle, causing 
it to contract more vigorously and more often (increasing 
the systole but not the diastole). 

Action on the Blood Vessels: The small blood vessels are 



BLOOD AND CIRCULATORY STIMULANTS 155 

made narrower by contraction of the muscle fibers in their 
walls. Impulses are also sent to these muscles from the 
spot of gray matter in the medulla of the brain which 
controls their contractions (the vaso motor center), and 
therefore the width of the blood vessels. This effect helps to 
increase the strength and frequency of the heart beats, and 
also increases the pressure of the blood in the blood vessels 
(blood pressure). 

As a result of these effects on the heart and blood vessels, 
the pulse is rapid and strong and the blood pressure (the 
pressure of the blood in the vessels) is increased. 

Respiration: After caffeine the patient usually breathes 
deeper and faster. This causes more air to be taken into 
the lungs. More oxygen can therefore be taken up by the 
red blood corpuscles. 

Muscles: Caffeine increases the contractions of all vol- 
untary muscles (biceps, triceps, etc.) and these muscles 
contract with less fatigue. As a result of this action, in- 
dividuals are able to do more physical work and with less 
fatigue. 

Action on the Brain: Caffeine increases the action of 
every part of the brain. Impulses reach the brain faster. 
More impulses are sent out from the brain, and these are 
sent out more rapidly. 

As a result of this action, the patient is more wakeful, 
brighter; he sees and hears better. He appreciates influences 
about him more easily and is able to respond to them more 
readily. The patient is able to think better, easier and 
faster. He reasons better, his ideas arise more easily and he 
can express these ideas with greater ease; and he can re- 
member better. The patient is more active, more talkative, 
and absolutely rational in everything he says or does. 

These effects result from increased action of the various 
regions of gray matter in the brain. For instance, the greater 
activity of the patient, is due to more impulses being sent 
out from that part of the gray matter of the brain which 
controls motion. The patient is brighter and wakeful 
because he is more susceptible to influences and impressions 
obtained from objects about him. He appreciates the 



156 MATERIA MED1CA 

impressions received through his various senses much better, 
and this helps to keep him wakeful. He reasons better, 
because the impressions which are received in the brain are 
rapidly combined into new ones. The memory is better, 
because impulses are sent out from the various parts of 
gray matter of the brain where old impressions had been 
stored up. 

Action on the Spinal Cord: The action of the spinal cord 
is increased by caffeine. As a result of this, the patient 
responds quicker and more actively to impressions received 
through his various senses (reflex action). For instance, 
the bowels move better because they respond faster when 
they become distended; the patient also responds much faster 
to any impression received through his senses such as pain, 
for instance. 

Action on the Kidneys: Caffeine increases the flow of 
urine. It causes the cells of the kidney to secrete more urine. 
By increasing its circulation it also brings more blood to the 
kidney from which it can secrete more urine. Caffeine is 
therefore one of the best diuretics. 

Excretion 

Caffeine is excreted mainly by the kidneys in a few hours. 
Very little caffeine is excreted as such. Most of it is changed 
to urea, which is a normal constituent of urine. 

Poisonous Effects 

Acute caffeine poisoning is very rare, because the caffeine 
is excreted very rapidly. The following symptoms were 
present in a few cases that have occurred: 

1. Headache. 

2. Confusion. 

3. Noises in the ear. 

4. Flashes of light. 

5. Delirium. 

6. Palpitation of the heart. 

7. Rapid weak pulse. 

8. Short quick breathing. 



BLOOD AND CIRCULATORY STIMULANTS 157 

9. Convulsive movements of the hands and tremors of 

various parts of the body. 

10. Profuse flow of urine. 

11. Collapse (pallor, cold moist skin, rapid thready pulse, 

slow and shallow breathing, cold extremities). 

Chronic Caffeine Poisoning — " Coffee Habit " 

This occurs particularly in people who drink strong coffee 
habitually. 

The patient is very nervous, is easily excited and disturbed 
even by the slightest noise. He is unable to sleep, complains 
of headache, palpitation of the heart and trembling of the 
fingers and hands. 

When the patient stops drinking coffee, all these symptoms 
disappear. 

Administration 

Caffeine is given in capsules, tablets or powders. Since 
its effects come on rapidly, and do not last for a long time, 
it is better to give small doses, frequently repeated, than a 
single large dose; so that when the effect of one dose wears 
off, the patient has some more caffeine to produce its effects. 

Uses 

Caffeine is one of the best drugs to increase heart action, 
especially where a rapid effect is desired. It is an excellent 
diuretic. It is very often combined with other drugs such 
as phenacetine, acetanilid, etc., to overcome their weaken- 
ing action on the heart. 

Preparations 

Caffeine 0.06-0.3 gm. grs. i-v 

(Caffeina) 

Caffeine Citrate 0.06-0.5 gm. grs. i-viii 

(Caffeina Citrata) 

Effervescent Caffeine Citrate 4.0 gms. 5i 

(Caffeina Citrata Effervescens) 

This is a mixture of caffeine citrate, sodium bicarbonate, 



158 MATERIA MEDICA 

tartaric acid and sugar, containing 4% of caffeine citrate. 
It effervesces when dissolved in water. 

Caffeine Sodium Benzoate 0.06-0.3 gm. grs. i-v 

(Caffeina Sodii Benzoas) 

(Unofficial) 

This is an excellent preparation for hypodermic use. 
It is usually kept in 25% stock solutions. 

Guarana 

Guarana is a paste made from the seeds of Paullinia 
sorbilis, a Brazilian plant. It contains caffeine and tannic 
acid. It is used for sick headache and neuralgia. In Brazil, 
it is also used to check diarrhoea because of the tannic acid 
which it contains. 

Preparations 

Fluidextract of Guarana 4.0-8.0 c.c. 3i-ii 

(Fluidextractum Guaranae) 

There are numerous preparations of the kola nut on the 
market. Many of them are used as stimulating drinks. 
They all contain caffeine. 

DIGITALIS GROUP 

The drugs in the following group, have practically the 
same action with slight differences. The most efficient, and 
best drug of the group is digitalis. The most important 
drugs in this class are, 

Digitalis Purpurea, Purple Foxglove 
Strophantus Hispidus or Kombe, Strophantus 
Scilla Maritima, Squills 

The following ones are less frequently used: 

Convallaria Majalis, Lily of the valley 
Helleborus Niger, Christmas rose 
Apocynum Canabinum, Canadian hemp 
Adonis Vernalis, Pheasant's eye 
Antiaris, Upas tree 
Nerium, Oleander 

and a number of others. 

Some of these drugs, for example strophantus, were used 



BLOOD AND CIRCULATORY STIMULANTS 159 

by the natives of Africa and in other Eastern countries as 
arrow poisons. Others were known for a long time before 
they were ever used in medicine. 

DIGITALIS 

Digitalis is a drug obtained from the leaves of the Digi- 
talis purpurea, or Purple foxglove, which grows in most 
temperate climates. The English leaves are the best. 

The leaves of the second year's growth are mostly used in 
making digitalis preparations, because they contain the 
largest amount of the active principles. 

There are four active principles in digitalis. All of them 
are glucosides. It also contains one inactive glucoside. 

The active glucosides in the order of their activity are: 

Digitoxin 
Digitophyllin 
Digitalin 
Digitalein 

The inactive glucoside is Digitonin. 

The active glucosides can all be dissolved in alcohol, while 
the digitonin can be dissolved in water. The tincture of 
digitalis therefore, does not contain any digitonin. 

The presence of the digitonin in the leaves, enables the 
active glucosides to be dissolved in water. Owing therefore, 
to the digitonin, it is possible to make up such preparations 
as the infusion or fluidextract. These preparations cannot 
be made if the digitonin is removed from the leaves, because 
the active glucosides cannot be dissolved in water. 

There are certain preparations of digitalis which are 
made from the seeds. They are called digitalines, and are 
unofficial. They contain digitalin and digitalein, and very 
small quantities of digitoxin, which is the most active 
glucoside of all. They are not very active preparations and 
are very unreliable. 

The most potent glucoside of digitalis is Digitoxin; which 
produces most of the digitalis effects. 

ACTION 
Local Action: Applied to the skin, digitalis causes smart- 



160 MATERIA MEDICA 

ing. If it is injected hypodermically, it is injurious to the 
tissues. It often causes inflammation and occasionally an 
abscess. 

On mucous membranes: It causes pain, redness, profuse 
secretion of mucus, and often inflammation. For ex- 
ample, if it is applied on the mucous membrane of the eye 
(conjunctiva) it causes redness, inflammation, and profuse 
flow of tears. If applied on the mucous membrane of the 
nose, it causes sneezing, profuse flow of mucus from the nose, 
(" running nose" or coryza) and inflammation. 

Internal Action 

In the mouth: Digitalis has a bitter taste and causes a 
burning sensation. 

In the stomach: many of the preparations of digitalis 
cause nausea and vomiting, because of the redness and 
swelling of the lining membrane of the stomach which they 
produce. This is due to the digitonin which these prepara- 
tions contain. The preparations that do not contain digito- 
nin, such as the tincture, or some of the newer preparations, 
are not so apt to cause nausea and vomiting. 

In the intestines: Digitalis occasionally causes diarrhoea, 
because of the redness and inflammation of the lining mem- 
brane of the intestines, which it produces. 

Action after Absorption 

Digitalis preparations are very slowly absorbed into the 
blood, through the lining membrane of the stomach. It 
usually takes about 12 to 24 hours to produce its effects. 
If given hypodermically, it enters the blood somewhat faster, 
so that the effects come on more rapidly. 

Since digitalis is so slowly absorbed, it produces con- 
tinuous lasting effects. It is, therefore, the best drug to give 
to a patient suffering from weakened heart action (myo- 
cardial insufficiency). 

After absorption, digitalis affects principally the heart, 
the blood vessels and the medulla of the brain. 

Action on the Circulation 
This is the most important action of digitalis. 



BLOOD AND CIRCULATORY STIMULANTS 161 

Action on the Heart: Digitalis makes the heart beat 
stronger and slower. It makes the heart muscle contract 
more vigorously, so that the heart completely expels its 
blood into the blood vessels (increases the systole). It also 
causes more impulses to be sent from the medulla of the 
brain along the Vagus or inhibitory nerves, which carry 
impulses to slow the heart, which, therefore, beats slower. 
The period of relaxation of the heart (diastole) is then 
greater, because the heart has more time to dilate or relax, 
between each contraction. 

The total effect on the heart is, that more blood enters 
the cavities of the heart during its period of relaxation; 
which is greater. More blood is pumped into the blood 
vessels; to be carried to the various organs and tissues of 
the body, owing to the stronger contractions of the heart. 

Action on the Blood Vessels: Digitalis contracts the mus- 
cle fibers in the walls of the small blood vessels, thereby 
making these vessels narrower. The narrower blood vessels, 
offer a greater resistance to the contractions of the heart. 
This greater resistance helps to increase the contractions of 
the heart muscle. More impulses are also sent from the 
medulla to make these muscle fibers contract. 

The pressure of the blood within the blood vessels (blood 
pressure) is much greater after digitalis. This is due to: 

1. The greater muscular contractions of the heart muscle 
itself, which sends more blood into the arteries with greater 
force. 

2. The contractions of the muscle fibers in the walls of the 
blood vessels, making these vessels narrower, helps to in- 
crease the pressure of the blood. 

The total effect of digitalis on the circulation is to produce: 

Regular strong slow contractions of the heart with greater 
blood pressure. The pulse is therefore slow, strong, regular and 
tense. 

More blood is pumped to the different tissues and organs 
of the body with greater force. The blood is better in quality, 
because it has been purified by a greater amount of air in 
the lungs. The various parts of the body are all supplied with 
more, and better blood, and are able to do their work better. 



162 MATERIA MEDICA 

The effect of digitalis on the heart can be compared to 
a driver driving a lagging horse. The lagging horse is the 
weakened heart, which is not doing enough work. The 
driver is the digitalis. 

The driver whips the horse to make him go faster and more 
energetically; but, lest the horse overwork himself by going 
too fast, the driver keeps him in check by pulling in the 
reins. The horse then works energetically, though not fast 
enough to exert himself. 

After digitalis, the heart also works energetically, but 
lest it overwork itself, it is checked by the slowing impulses 
of the Vagus or inhibitory nerves, which prevent it from 
becoming exhausted. 

Action on the brain: Digitalis affects the medulla of the 
brain, especially that part of the gray matter of the medulla, 
which sends out impulses to slow the heart (vagus center), 
and the part of gray matter for sending impulses to contract 
the muscle fibers of the blood vessels (vaso motor center). 
In overdoses, it also sends out impulses for vomiting; and in 
such doses the impulses for motion are also very much in- 
creased, thereby producing convulsions. 

Action on the kidney: Digitalis increases the flow of urine 
very markedly; especially in cases where the tissues con- 
tain a great deal of fluid (oedema). This is due to the 
improvement of the circulation of the kidney, which results 
from digitalis. The improvement of the circulation through- 
out the body causes the absorption of the fluid from the 
tissues, lessening the oedema. The absorbed fluid is brought 
to the kidneys. This helps to increase the secretion of urine; 
since there is more fluid to be excreted. 

Temperature: Digitalis often lowers the temperature. 

Excretion 

The body gets rid of digitalis very slowly. It begins to 
be excreted a few days after it is given. As a result of its 
slow excretion, some of the digitalis accumulates in the body, 
and cumulative symptoms, or chronic digitalis poisoning 
results. 



BLOOD AND CIRCULATORY STIMULANTS 163 

Poisonous Effects 

Since digitalis is slowly absorbed, and excreted still slower, 
it does not cause acute poisonous symptoms. 

Digitalis Poisoning or Cumulative Symptoms 

Cumulative symptoms result from continued administra- 
tion of digitalis. These can often be avoided, by giving 
digitalis for a time; then stopping its administration for a 
while, to allow the body to get rid of the digitalis which it has 
accumulated. 

Symptoms 

The first symptom of excessive digitalis action, is con- 
tinuous nausea and vomiting, lasting for two or three days. 
There may also be diarrhoea. The patient then complains 
of weakness, headache and disturbance of vision. (He may be 
unable to see objects clearly, they may seem to vibrate, and 
there may be spots before the eyes.) There may also be 
buzzing in the ears, often the patient feels dizzy. 

The pulse becomes slow, about 40 to 50 beats to the minute, 
irregular, weak and small. On the slightest exertion, however, 
the pulse becomes very rapid, even 130 or 150 beats to the 
minute, though it is very weak and irregular. The breathing 
is rapid and shallow. Very little urine is passed. 

The continuous vomiting finally exhausts the patient. The 
face is pale, the eyeballs protrude, the pupils are dilated, 
the pulse becomes very rapid, intermittent and weak. The 
breathing becomes very rapid and shallow. The patient is 
conscious, however, though he may be delirious. Finally 
convulsions develop, and death ensues. 

Death usually occurs in two or three days from weakened 
heart action. 

The most important symptom of digitalis poisoning, is 
the slow and irregular pulse. Whenever digitalis is given to 
a patient, and the pulse gets to about 40 or 50 and be- 
comes irregular, it means the patient is getting too muchi 
digitalis and the drug should be stopped. 

The excessive slowness of the pulse means that the heart 
is overworking, and impulses are being sent along the Vagus 



164 MATERIA MEDICA 

nerves to check this overwork. These excessive impulses to 
slow the heart cause the slow pulse. If, however, digitalis 
is still given, in spite of the slow pulse, the vagus nerve 
becomes paralyzed; and its influence on the heart is gone. 
The heart then beats very rapidly and the pulse is very 
rapid and intermittent. This occurs in the late stages of 
digitalis poisoning. 

Treatment of Digitalis Poisoning 

1. Stop the digitalis as soon as the pulse gets below 50 and 
is irregular. 

2. Keep the patient absolutely quiet; because a sudden 
exertion may be fatal. 

3. Wash out the stomach. 

4. Give cathartics to clean out the bowels. 

5. Give preparations of tannic acid or tannin (such as 
old tea) to neutralize the digitalis. 

6. Give alcoholic preparations such as whiskey, or am- 
monia preparations such as ammonium carbonate, to keep 
up the heart action. 

7. Give preparations of opium or morphine to keep the 
patient quiet and prevent the heart from overacting. 

Administration 

For rapid effect, as in collapse, only some of the newer 
unofficial preparations can be given. They act quicker than 
other preparations and can be given hypodermically. 

All preparations of digitalis should be given after meals. 
They should be fresh and made from reliable English leaves. 
The failure to obtain results from digitalis is often due to 
unreliable preparations. 

Weakened Heart Action or Myocardial Insufficiency 

The contractions of the heart keep the blood circulating 
through the blood vessels, so that the tissues and organs of 
the body may be supplied with nourishment and oxygen, 
and their waste products removed. 

When the heart is diseased; for example, when its valves 
are narrowed (stenosis), or when they are leaking (regur- 
gitation), the heart overcomes this difficulty, by its wall 



BLOOD AND CIRCULATORY STIMULANTS 165 

getting thicker; so that the heart is then able to contract 
with greater force to overcome the leaking or narrow valves. 
The heart is then said to be compensated. 

When, however, the heart muscle is weak, the blood can- 
not be moved along the blood vessels fast enough. Some 
of the blood then accumulates in the veins of the lungs, of 
the extremities and of the abdomen. 

When the blood accumulates in the blood vessels of the 
lungs, the air sacs become narrower. The patient therefore, 
has to breathe faster and deeper to get the proper amount 
of air in his lungs. The blood corpuscles therefore, do not 
take up enough oxygen, and the blood is then darker in 
color and the patient looks blue. 

Some of the blood also accumulates in the veins and 
capillaries of the extremities. Some of the serum of this 
accumulated blood, oozes through the walls of the vessels 
into the surrounding tissues. The tissues, particularly of 
the lower extremities, then become full of fluid (oedema). 

In the abdomen too, the accumulation of the blood, in 
the blood vessels of the stomach and intestines, results in 
congestion and oedema of the stomach and intestines. This 
produces nausea, vomiting and diarrhoea. 

The accumulation of the blood in the kidneys, results 
in lessened secretion of urine, because the kidney is not sup- 
plied with sufficient fresh blood from which to excrete urine. 

Often the serum oozes through the walls of the blood 
vessels into the abdomen, filling it up with fluid (ascites). 

As a result of this weakened heart action, patients present 
the following picture: 

At first they are very short of breath and the face is blue 
(cyanosed). Later the extremities are swollen (oedema), and 
in some cases, the patients have nausea, vomiting and even 
diarrhoea. The pulse is rapid, often irregular and weak. 

Appearance of the Patient after Digitalis 

When digitalis is given, all these symptoms disappear. 
Within a few days after its administration is begun, the 
patient breathes easier, the blueness of the skin disappears. 
The swelling of the extremities (oedema) gradually becomes 



166 MATERIA MEDICA 

lessened, until it finally disappears. The pulse is stronger 
and slower. More urine is passed and the nausea and vomit- 
ing disappear. 

Preparations 

Solid Preparations 

Digitalis (Powdered leaves) 0.03-0.1 gm. grs. ^-ii 

(Digitalis) 

Extract of Digitalis 0.0075-0.03 gm. grs. f-J 

(Extractum Digitalis) 

Fluid Preparations 

Infusion of Digitalis 4.0-16.0 c.c. 3H5i 

(Infusum Digitalis) 

The usual official infusion is a 1.5% solution, or one part 
of digitalis to 661 parts of water. 

Many physicians order weaker infusions; such as 1-150 
etc. The dose for such infusions is correspondingly greater. 

Fluidextract of Digitalis 0.06-0.12 c.c. m. i -ii 

(Fluidextractum Digitalis) 

Tincture of Digitalis 0.3 -1.0 c.c. m. v-xv 

(Tinctura Digitalis) 

This preparation does not contain digitonin, and is there- 
fore not so apt to upset the stomach. 

New and Non-official Preparations 

The following preparations are not official. Many of 
them are used extensively and are very reliable. Some of 
them can be given hypodermically, because they do not 
form abscesses and produce effects rapidly. 

Digalen 0.06-2.0 c.c. m. x-xxx 

(Liquor Digitoxin Solubilis) 

Digalen is a solution containing digitoxin, the most ac- 
tive glucoside of digitalis. It is dissolved in a mixture of 
distilled water, glycerin and a very small amount of alcohol. 
The digitoxin in this preparation has been prepared so that 
it may be easily dissolved. It is given hypodermically, and 
produces its effects in from one to two hours. 



BLOOD AND CIRCULATORY STIMULANTS 167 

It is also given intravenously in doses of 0.3 — 1.0 c.c. 
(m. v-xv) producing effects in from 15 minutes to a half hour. 
It can be repeated intravenously in these doses about every 
half to one hour. 

Digalen Tablets: Each tablet contains the same amount of 
digitoxin that is contained in 0.5 c.c. (m. viii) of digalen. 

Digipuratum: Digipuratum is a preparation of digitalis 
from which many of the inactive substances have been re- 
moved. It contains no digitonin, and is therefore not apt 
to cause nausea and vomiting. 

It is made from specially grown leaves, and the dose is 
regulated and accurate. Each dose contains enough digi- 
toxin to kill a frog weighing 30.0 gms. by stopping the beating 
of its heart. 

Digipuratum Tablets 0.1 gm. gr. i| 

These tablets are given in the following way; one tablet 
four times a day, and giving one tablet less every day, until 
ten tablets are taken. The digipuratum is then stopped. 
This allows the body to get rid of the drug which it has ac- 
cumulated. Cumulative symptoms are thus avoided. 

Digipuratum also comes in vials for hypodermic use. 
Each vial contains 1.0 c.c. of fluid, and is equivalent to 0.1 gm. 
(gr. ii) of digipuratum. 

Digitoxin 0.00025 gm. gr. -^hr 

This is not often used, as it cannot be dissolved easily. 

Digitol 0.3-1.0 c.c. m. v-xv 

There are several preparations of digitalins. Some of 
them are called German or French digitalins. They are not 
used very much because their action is unreliable. Many 
of them are made from the digitalis seeds, and contain very 
few active principles. 

STROPHANTUS (STROPHANTUS) 

Strophantus is a drug obtained from the ripe seeds of the 
Strophantus hispidus, a climbing shrub of Africa. It has 
been used for a long time by the natives of that country, as 



168 MATERIA MEDICA 

an arrow poison under various names; such as kombe", inee*, 
ouaye, or pahouius poison. 

Its active principle is a glucoside, strophantin. 

ACTION 

Strophantus produces the same effects as digitalis. 

Local Action: Applied to the skin, it causes smarting. 
If injected hypodermically, it is apt to cause abscesses. 

On mucous membranes : It causes intense redness, swelling, 
profuse secretion of mucus, and often inflammation. 

Internal Action 

In the stomach : It slightly increases the secretion. It does 
not cause nausea and vomiting. 

In the intestines : The secretions of the mucous membrane 
are slightly increased. 

Action after Absorption 

Strophantus is absorbed more rapidly than digitalis, 
usually in about 12 hours. After absorption, it affects 
principally the heart, muscles and the kidney. 

Action on the Heart: Strophantus makes the heart beat 
slower and stronger. The pulse is strong and slow like the 
digitalis effect. Strophantus does not contract the blood vessels 
as much as digitalis. 

Action on the Muscles: One of the most important effects 
of strophantus is its action on the muscles. It makes them 
contract more vigorously. 

Action on the Kidneys: Strophantus increases the flow 
of urine because it improves the circulation of the kidney. 

Excretion 

Strophantus is excreted mainly by the kidneys; much 
more rapidly however, than digitalis. It does not therefore, 
cause cumulative symptoms. 

Poisonous Effects 

The poisonous symptoms of strophantus are the same as 
those of digitalis. (See Digitalis.) 



BLOOD AND CIRCULATORY STIMULANTS 169 

Uses 

Strophantus is often used instead of digitalis, when the 
patient cannot stand the ordinary digitalis preparations, 
because of the nausea and vomiting which these often pro- 
duce. 

Preparations 

Tincture of Strophantus 0.3-1.0 c.c. m. v-xv 

(Tinctura Strophanti) 

Strophantin 0.001 gm. gr. -fa 

(The active glucoside) 

This is not very reliable, since its composition varies. It 
must be freshly prepared. 

Ouabain 

(Crystallized Strophantin) 0.003-0.025 gm. gr. -fo-i 

(Unofficial) 

This is also given intramuscularly, well diluted in doses 
of gr. T ^. 

Ouabain is a preparation of strophantin which is said to be 
more active than the ordinary strophantin. 

SQUILLS (SCILLA) 

Squills is obtained from the bulb of the Unginea maritima 
or squills maritima, or the sea onion, a plant growing in the 
southern part of Europe. The outer coat of the bulb is 
removed, and the bulb is then cut into slices. From these 
slices the preparations are made. The active principle is a 
glucoside, scillain. 

ACTION 

Squills acts mainly like digitalis. 

Local action: Applied to the skin, it causes smarting and 
pain. On mucous membranes, it causes redness, swelling, 
with excessive secretion of mucus. 

The mucous membrane of the eye, the nose, are all affected 
by squills. It makes them all secrete mucus very profusely. 



170 MATERIA MEDICA 

Internal Action 

In the mouth : Squills has a bitter taste. 

In the stomach : It often causes nausea and vomiting, owing 
to the profuse secretion of the lining membrane of the stom- 
ach which it produces. 

In the intestines: It often causes diarrhoea. 

Action after Absorption 

Squills is absorbed much faster than digitalis. After 
absorption it acts upon the heart, the blood vessels, mucous 
membranes and the kidneys. 

Action on the heart: Squills acts like digitalis on the 
heart. It makes it beat stronger and slower. The pulse 
after squills is therefore stronger and slower. 

Action on mucous membranes: Squills increases the secre- 
tion of all the mucous membranes when given internally, 
especially the mucous membrane of the bronchi. It is used 
very often as an expectorant; to increase the cough and 
expectoration, particularly in old people. 

Action on the kidney: It increases the flow of urine by im- 
proving the circulation of the kidney. It is often given 
together with digitalis for this purpose. 

Excretion 

Squills is excreted by the kidneys; more rapidly than 
digitalis. 

Poisonous Effects 

Overdoses of squills cause the following symptoms: 

1. Severe abdominal pain. 

2. Violent nausea and vomiting. 

3. Profuse diarrhoea. 

4. Scanty urination, often with bloody urine. 

5. Slow pulse. 

6. Collapse; (rapid, thready, weak pulse, slow and shallow 
breathing, pale, cold, moist skin). 

7. Convulsions; usually before death. 



BLOOD AND CIRCULATORY STIMULANTS 171 

Treatment 

1. Wash out the stomach. 

2. Give cathartics to move the bowels. 

3. Treat the collapse: Keep the patient warm; give heart 
stimulants such as caffeine, strychnine, atropine, etc. 

Preparations 

Tincture of Squills 0.3-1.0 c.c. m. v-xv 

(Tinctura Scillae) 

Syrup of Squills 2.0-4.0 c.c. 3H 

(Syrupus Scillae) 

Compound Syrup of Squills 0.6-2.0 c.c. m. x-xxx 

(Syrupus Scillae Compositus) 

This contains squills, senega and tartar emetic. 

Guy's or FotherguTs Pill 

This contains: 

Calomel 

Squills 

Digitalis (powdered leaves) of each 0.06 gm. (gr. i). It 
is an excellent diuretic. 

Squills is usually given in pill form for diuretic action. 
As an expectorant the syrup is usually given. 

CONVALLARIA (LILY OF THE VALLEY) 

Convallaria is obtained from the roots and underground 
stems of the Convallaria majalis or lily of the valley. 

The active principles are glucosides; convallarin and con- 
vallamarin. 

Convallamarin acts on the heart, while convallarin acts 
on the stomach and intestines. 

ACTION 

Convallaria acts like digitalis, but it is not as reliable. 

Local action: Applied to the skin, the preparations of 
convallaria cause smarting and pain. 

On mucous membranes: It causes redness and swelling, 
with profuse secretion of mucus. 



172 MATERIA MEDICA 

Internal Action 

In the stomach : It often causes nausea and vomiting. 
In the intestines: It increases the secretion of the lining 
membrane, often causing diarrhoea. 

Action after Absorption 

Convallaria is absorbed from the stomach more rapidly 
than digitalis. 

After absorption, it affects principally the heart, blood 
vessels and kidney. 

Action on the heart: Convallaria makes the heart beat 
stronger and slower. It also contracts the blood vessels. 
The pulse is therefore slow and strong, and the blood pressure 
is greatly increased. 

Action on the kidney: Convallaria increases the flow of 
urine by improving the circulation of the kidney. 

Excretion 

Convallaria is excreted mainly by the kidney; more 
rapidly than digitalis. It does not cause cumulative symp- 
toms. 

Uses 

Convallaria is used as a substitute for digitalis to relieve 
dropsy (fluid in the tissues), in heart disease and kidney 
disease. It is not as efficacious nor as reliable as digitalis. 

Convallaria was used for dropsy by the Russian peasants 
long before it was ever used in medicine. 

Poisonous Effects 

The poisonous symptoms of convallaria are quite similar 
to those of digitalis. 

The following are the usual symptoms of an overdose. 

1. Nausea, vomiting. 

2. Diarrhoea. 

3. Slow irregular pulse with very high blood pressure. 
Later the pulse becomes very rapid. 

4. Deep prolonged breathing, which later becomes slow 
and deep. 

The patient finally dies from stopping of the heart action. 



BLOOD AND CIRCULATORY STIMULANTS 173 

Treatment 

1. Stop the drug. 

2. Wash out the stomach. 

3. Give cathartics. 

4. Give heart stimulants if necessary. 

Preparations 
Fluidextract of Convallaria 0.3-1.0 c.c. m. v-xv 

(Fluidextractum Convallariae) 

Convallarin 0.03-1.2 gm. gr. ^ — ii 

(Convallarinum) 

(Not official) 

This is not often used because it is unreliable. 

APOCYNUM (CANADIAN HEMP) 

Apocynum is obtained from the root of the Apocynum 
cannabinum, Canadian hemp or milkweed. 

Its active principle is a glucoside apocynein. Apocynin 
is another inactive principle present in apocynum. 

ACTION 

Apocynum produces the same effects as digitalis. 

Local action: Applied to the skin, it causes smarting and 
redness. On mucous membranes it causes redness, swelling 
and excessive secretion of mucus. 

Internal Action 

In the stomach: It often causes nausea and vomiting by 
increasing the secretion of the mucous membrane of the 
stomach. 

In the intestines : It increases the secretion of the mucous 
membrane, thereby producing diarrhoea. 

Apocynum is an excellent laxative in small quantities, 
but it is not often used for this effect. 

Action after Absorption 

Apocynum is slowly absorbed; though much more rapidly 
than digitalis. After absorption it affects principally the 
heart and the kidneys. 



174 MATERIA MEDICA 

Action on the heart: The heart beats slower and stronger; 
the pulse is therefore slow and strong after apocynum is 
given. 

Action on the kidneys: It increases the flow of urine by 
improving the circulation of the kidney. 

Excretion 

Apocynum is excreted mainly by the kidney. 

Uses 

It is used principally as a diuretic, but its action cannot 
be relied upon. 

The poisonous effects are the same as those of digitalis. 

Preparations 

Fluidextract of Apocynum 0.3-2.0 c.c. m. v-xxx 

(Fluidextractum Apocyni) 

ADONIS VERNALIS (not official) 

Adonis vernalis is the root of the Adonis vernalis, a 
plant of northern Europe and Asia. 

Its active principle is a glucoside, adonidin. 

ACTION 

Adonis vernalis acts exactly like digitalis. It is more 
rapidly absorbed, however, and does not cause cumulative 
symptoms. It is used as a substitute for digitalis, or it is 
occasionally given with digitalis. 

It is very expensive and its effects are not reliable. 

Preparations 

Infusion of Adonis Vernalis 

1-4% in strength 

Adonidin (active principle) 0.02 gm. gr. £ 

(Not official) 



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176 MATERIA MEDICA 

CAMPHOR (CAMPHORA) 

Camphor is obtained from the Laurus camphora or Cin- 
namomum camphora, an evergreen tree growing in China and 
Japan. 

It is made by chopping up the root, stems and branches 
of the tree into fine pieces and boiling them in water. The 
volatile oil which the plant contains then rises to the top. 
When the fluid is allowed to cool, part of the oil evaporates 
and leaves a thick film; which is the camphor. This is then 
skimmed off, purified and used as a drug. 

This sediment which remains when a volatile oil evaporates 
is called a stearoptene. 

Another similar stearoptene used in medicine is menthol, 
which is obtained from the oil of peppermint. 

Thujon is a substance similar to camphor which is present 
in the oil of wormwood, and therefore in absinthe, and causes 
the convulsions of chronic absinthe drinkers. 

Camphor has been used by the Chinese for many centuries. 

Appearance of the Patient 

About a half to one hour after an ordinary dose of cam- 
phor is given, the patient becomes calm and quiet, though 
somewhat exhilarated. He has a feeling of warmth in the 
stomach. The pulse is strong and rapid (sometimes slow) 
and the patient breathes faster and easier. When it is given 
hypodermically, these effects come on sooner. 

ACTION 

Local action: Applied to the skin, camphor causes red- 
ness and a feeling of warmth. It relieves pain at the spot 
where it is applied, and is slightly antiseptic. 

On mucous membranes: It causes redness with profuse 
secretion of mucus. 

Internal Action 

In the mouth : It has a hot bitter taste. 

In the stomach: It causes a feeling of warmth, checks the 



BLOOD AND CIRCULATORY STIMULANTS 177 

formation, and hastens the expulsion of gas (carminative 
action). 

In the intestines : It often checks diarrhoea and aids in the 
expulsion of gas. 

Action after Absorption 

Camphor is absorbed from the stomach in a few hours. 
After absorption it affects principally the heart, the respira- 
tion, the brain and slightly the muscles. 

Action on the heart: Camphor makes the heart beat 
stronger. The rate may be faster or slower. 

The blood vessels are widened however, so that the pulse 
has a bounding quality. The pulse is therefore always 
stronger and bounding, sometimes faster and at other times 
slower. 

Action on the respiration: Camphor makes the patient 
breathe faster and deeper. This action is not always 
marked. 

Action on the brain: In the doses that camphor is 
usually given, it makes the patient feel calm and quiet, 
though somewhat exhilarated. This is produced by slightly 
lessening the action of the brain. In larger doses the action 
of the brain is increased. The patient then becomes more 
active and more talkative. 

In poisonous doses, the action of the brain is increased 
so much, the brain sending out so many impulses, for mo- 
tion, speech, etc., that it often causes convulsions and de- 
lirium. 

Action on the muscles: Camphor slightly increases the 
contractions of the muscles. 

It often also increases sexual excitement. 

Excretion 

Most of the camphor that is taken, is used up by the 
tissues of the body. The rest of it is changed to camphorol, 
which is eliminated from the body by the kidneys; in com- 
bination with other ingredients of the urine. Camphor is 
excreted in a few hours. 



178 MATERIA MEDICA 

Poisonous Effects 

Overdoses of camphor produce the following symptoms; 
though they are rarely fatal: 

1. Burning pain in the stomach. 

2. Headache. 

3. Dizziness. 

4. Delirium. 

5. Convulsions. 

6. Unconsciousness. 

7. Weak small pulse, rapid or slow. 

8. Pale, cold moist skin. 

These symptoms disappear when the drug is stopped. 

Uses 

Preparations of camphor such as the liniment, are used to 
relieve pain; in sprains or muscular rheumatism. 

It is used as a heart stimulant, and often to lessen nerv- 
ousness. 

Recently, pneumonia has been treated by repeated intra- 
muscular injections of 10 c.c. (3iii) doses of camphor oil. 

This treatment is used, because it has been found that 
camphor checks the growth of the Pneumococcus, the 
bacterium which causes pneumonia. It is then supposed 
to act as a specific in pneumonia, and at the same time to 
strengthen the heart action. 

Preparations 
Solid Preparations 
Camphor 0.1-0.6 gm. grs. ii-x 

(Camphora) 

Monobromated Camphor 0.3-1.0 gm. grs. v-xv 

(Camphora Monobramata) 

This is occasionally used to relieve nervousness, hysteria, 
and sexual excitement. 

Fluid Preparations 
Camphor Water 1.0-4.0 c.c. m. xv-5i 

(Aqua Camphorae) 
(Strength 1-125) 



BLOOD AND CIRCULATORY STIMULANTS 179 

Spirits of Camphor 0.3-2.0 c.c. m. v -xxx 

(Spiritus Camphorae) 

(Strength 10%) 

This is much stronger than the camphor water. 

Camphor Oil 0.3-0.6 c.c. m. v-x 

(Oleum Camphorae) 

This is rarely used. 

Camphor Liniment or Camphorated Oil 2.0 c.c. m. xxx 
(Linimentum Camphorae) 

This is a 20% solution of camphor in cottonseed oil. 
It is used locally to relieve pain. 

It is extensively used, however, for hypodermic use as 
a heart stimulant; and in doses of 10 c.c. in the treatment 
of pneumonia. It should always be injected deeply into 
the muscles. 

Soap Liniment 
(Linimentum Saponis) 

This contains about 5% of camphor, 6% of soap, 70% of 
alcohol, and oil of rosemary. It is used locally to relieve 
pain. 



AMMONIUM 

Ammonium is a solution of ammonia gas in water. 
Ammonia is a combination of one part of nitrogen gas and 
three parts of hydrogen gas. Ammonia gas isj formed 
when animal matter decays. It is a strong alkali. 

Appearance of the Patient 

When ammonia gas is inhaled, it causes redness of 
the conjunctiva of the eye, a profuse flow of tears, and 
a profuse flow of mucus from the nose, and sneezing; 
due to the redness and swelling of the mucous mem- 
branes. 

It also causes severe coughing with excessive secretion 
of mucus from the bronchi. This is due to the redness and 



180 MATERIA MEDICA 

swelling (irritation) of the lining membrane of the bronchi 
which ammonia produces. The pulse is stronger and faster, 
and the breathing is deeper and more rapid. 

These effects come on almost immediately, but last for 
a very short time. 

ACTION 

Local action: A weak solution of ammonia causes redness 
and softening of the skin. It makes the skin feel slippery, as 
if it were covered with soap. Stronger solutions, if kept in 
contact with the skin and prevented from evaporating, form 
blisters (vesication), often destroying the skin (escharotic 
action). 

On mucous membranes : It causes redness and swelling with 
profuse secretion of mucus. The same destructive action as 
on the skin, results if it is allowed to remain in contact with 
the mucous membrane. For example — on the conjunctiva 
it causes redness and profuse flow of tears. In the nose: It 
causes redness, swelling, profuse flow of mucus and sneezing. 
In the bronchi: When inhaled, or when given internally, it 
causes an excessive secretion of mucus which is somewhat 
more fluid in character. 

Internal Action 

In the mouth : Ammonia has a pungent taste, it causes red- 
ness and swelling of its hning membrane, and it increases 
the flow of saliva. 

In the stomach: It causes redness and swelling of the 
mucous membrane and increases the secretion of gastric 
juice. It neutralizes the hydrochloric acid of the gastric 
juice so that it therefore lessens the digestion of food. 

When ammonia is absorbed from the lining membrane 
of the stomach, it produces no effects; because it is changed 
at once to urea, one of the constituents of the urine. It 
increases however, the amount of urea in the urine. 

Ammonia is usually given by inhalation and it produces 
its effects in this manner. The effects are not very lasting. 
When given by the mouth, the same effects are produced, 
and they are then more lasting; though the drug is not 
absorbed from the stomach. 



BLOOD AND CIRCULATORY STIMULANTS 181 

Action after Inhalation 

Ammonia affects principally the heart and the respiration. 

Action on the heart: It makes the heart beat stronger 
and faster, causing a strong and fast pulse. 

Action on the respiration: The breathing is more rapid 
and deeper after ammonia. 

These effects are not due to absorption of the drug, but to 
the redness and swelling (irritation) of the mucous membrane 
of the eyes, nose and bronchi. 

This irritation also affects the nerve endings in these 
mucous membranes, which then send impulses to the medulla 
of the brain. The medulla at once sends back impulses along 
the accelerator nerves, to make the heart beat stronger and 
faster, and to increase the depth and frequency of the 
breathing (reflex action). These effects appear almost im- 
mediately, and last for a very short time. 

When given by the stomach, the same effects are produced, 
but they are more lasting. The effects are not produced by 
the absorption of the drug, but by the reflex action resulting 
from the redness and swelling (irritation) produced on the 
mucous membrane of the stomach. 

Excretion 

Ammonia is excreted as urea, a normal ingredient of the 
urine. The urine therefore contains a larger amount of 
urea. It is also excreted by the profuse secretion of the 
mucous membrane of the bronchi which it produces. 

Effects after Intravenous Injections 

If ammonia or any of its salts are injected into the veins, 
it markedly increases the frequency and depth of breathing. 
It makes the heart beat stronger and faster, and it often 
causes convulsions. 

Poisonous Effects 

Acute Ammonia Poisoning 
When a strong solution of ammonia is taken, the following 
symptoms result almost immediately. 



182 MATERIA MEDICA 

The patient complains of severe burning pain in the 
mouth, throat and stomach. The lips, mouth, throat, oesoph- 
agus and larynx are inflamed and swollen. Often the 
superficial tissues of these organs are destroyed. The 
swelling of the larynx may be so severe as to obstruct the 
breathing and the patient may choke to death because he is 
unable to get air into his lungs. 

In addition to these symptoms, the patient feels nauseated, 
and vomits profusely. The vomited matter contains blood 
and pieces of the mucous membrane of the stomach. 

The continual vomiting and the destruction of the lining 
membrane of the stomach, produce severe collapse : Pale, cold 
moist skin; rapid, weak, thready pulse; slow, shallow breath- 
ing; finally stupor, coma and death. Sometimes however, 
the mind remains clear to the last. 

Death may result in a few minutes from asphyxia, or 
later from collapse. 

If the patient recovers, the resulting scars which form in 
the oesophagus from the destruction of the tissues, may 
cause narrowing (stricture) of the oesophagus. 

This causes severe symptoms on account of the lack of 
nourishment, from the inability to swallow food. 

Treatment 

1. Neutralize the ammonia with dilute acids, that do not 
harm the patient of themselves. 

Vinegar and lemon juice are the best acids to use. 

2. Protect the lining membrane of the oesophagus and 
stomach with milk, oils, albumin water and other protecting 
drinks. 

3. Treat the collapse with heart stimulants such as 
caffeine, atropine, strychnine. 

4. Do not keep the patient warm; as heat increases the 
action of ammonia. Apply cold applications to the head and 
give plenty of cold air. 

5. If the patient suffers from asphyxia, the trachea must 
be opened (tracheotomy) to save the patient's life. 

6. For the resulting narrowing (stenosis) of the oesophagus, 



BLOOD AND CIRCULATORY STIMULANTS 183 

bougies must be passed, or surgical interference may be 
necessary. 

Uses 

Ammonia is used: 

1. As a heart stimulant for temporary effect, for example 
in fainting. 

2. In the form of liniments, to relieve pain. 

3. To neutralize the acid of the gastric juice. 

4. To check the formation of gas in the stomach. 

5. To increase the cough and expectoration. 

Preparations 
Fluid Preparations 
Strong Ammonia Water 
(Aqua Ammoniae Fortior) 

It contains about 28% of ammonia gas. It is never 
given internally. It is used locally, applied to snake bites 
and to form a blister to withdraw fluid from the deeper 
tissues. 

Ammonia Water 0.6-2.0 c.c. m. x-xxx 

(Aqua Ammoniae) 

This contains 10% of ammonia gas. 

Aromatic Spirit of Ammonia 2.0-4.0 c.c. 5i~i 

(Spiritus Ammoniae Aromaticus) 

This contains ammonia water and 4% of ammonium car- 
bonate, together with the oil of nutmeg, oil of lemon 
and oil of lavender. 

It is used principally to overcome fainting, as a carmina- 
tive, and to relieve nausea. 

Solution of Ammonium Acetate 4.0-16.0 c.c. 5i-iv 

(Liquor Ammonii Acetatis) 

(Spirit of Mindererus) 

This is used principally to increase sweating (diaphoretic) 
and to increase the flow of urine (diuretic). 

For Local Use 
Ammonia Liniment 
(Linimentum Ammoniae) 



184 MATERIA MEDICA 

This is a 3i% solution of ammonia in alcohol and cotton- 
seed oil. 

Solid Preparations 

Ammonium Carbonate 0.3-0.6 gm. grs. v-x 

(Ammonii Carbonas) 

This is used as a heart stimulant and as an expectorant. 

Ammonium Chloride 0.3-1.3 gm. grs. v-xx 

(Ammonii Chloridum) 

This is used principally as an expectorant (see page 199). 

There are numerous other salts of ammonium, such as 
ammonium bromide, ammonium iodide, etc. They are 
used principally for the effect of the bromide, iodide, etc. 
The combination with ammonium, however, makes them 
more strengthening to the heart. 

The following drugs are used extensively as heart stimu- 
lants. Their general action will be considered later. 

ATROPINE 

Atropine makes the heart beat stronger and faster. It 
paralyzes the nerve endings in the heart, of the Vagus, or 
inhibitory nerves, which carry impulses to make the heart 
beat slower. When the nerve endings of these nerves are 
paralyzed, these impulses are cut off. The heart therefore 
beats stronger and faster. The pulse, after atropine, is 
therefore stronger and faster. 

For other actions and preparations, see page 248. 

STRYCHNINE 

Strychnine makes the heart beat slower and stronger. It 
causes the medulla of the brain to send impulses along the 
Vagus, or inhibitory nerves to make the heart beat slower. 
It also contracts the blood vessels, and by thus offering 
greater resistance to the heart, makes the heart beat stronger. 
The pulse is therefore slower and stronger after strychnine. 

For other actions and preparations, see page 273. 



BLOOD AND CIRCULATORY STIMULANTS 185 



ALCOHOL 

Alcoholic liquors make the heart beat stronger and faster. 
Because the blood vessels are widened (dilated) the pulse 
has a bounding quality; since the contractions and relaxa- 
tions of the heart can be more easily transmitted along the 
wider blood vessels. 

The pulse after alcohol is therefore strong, fast and bounding. 
The effects, however, last only for a very short time, usually 
for about an hour or two. For hypodermic use, whiskey is 
the preparation commonly used. 

For other actions and preparations, see page 233. 

MUSK 

Musk is occasionally used as a heart stimulant. It is 
very expensive and very unreliable. When its effects are 
produced, it makes the heart beat stronger and faster. The 
pulse is therefore stronger and faster. The effects wear off 
very quickly. 

For other actions and preparations, see page 456. 



DRUGS ACTING ON THE BLOOD VESSELS 
VASCULAR STIMULANTS 

ADRENALIN 

Adrenalin is an extract containing all the active prin- 
ciples, of the suprarenal or adrenal glands of the sheep or ox. 
The adrenal gland is a small triangular gland situated im- 
mediately above the kidney. 

Appearance of the Patient 

After an intravenous or hypodermic injection of adrena- 
lin, the following effects are noticed within 15 or 20 minutes 
after it is given: 

The skin becomes pale, all the visible mucous membranes, 
such as the lips and conjunctiva become pale and blanched. 
The pupils are dilated. There is an excessive secretion of 
saliva and mucous in the mouth. 

The pulse is slow, strong, and very tense; the blood 
pressure being greatly increased; so that it is difficult to 
obliterate the pulse by pressure with the finger. The 
breathing is somewhat deeper. These effects wear off in an 
hour. 

ACTION 

Local action: Applied to the skin, it has no action. If 
applied to a bleeding point, it checks the bleeding by 
contracting the blood vessels. On mucous membranes: 
Adrenalin has a decided effect. It makes the mucous mem- 
branes pale and contracts them. This effect is produced 
by the marked contraction of the muscle fibers in the walls 
of the small blood vessels underneath the mucous membrane. 
These are also affected by direct application of adrenalin 
to the mucous membrane. 

For example — if applied to the conjunctiva of the eye, 
adrenalin makes it pale, it widens the eyelids, dilates the 
pupils and slightly protrudes the eyeball. In the nose: It 

186 



BLOOD AND CIRCULATORY STIMULANTS 187 

makes the mucous membrane pale and contracted, and 
thereby widens the nasal cavities. 

Internal Action 

In the mouth: The lining membrane becomes pale and 
contracted. 

Since adrenalin is an extract of a gland (an organ of 
the body), it is digested by the gastric juice of the stomach. 
It therefore produces no effect when given by the mouth. 

To obtain its effects, it must be given either intrave- 
nously, intramuscularly or hypodermically. 

Action after Absorption 

When given intravenously, the effects appear in about 
five to ten minutes. When given intramuscularly or hy- 
podermically, the effects appear within a half hour. 

After absorption, adrenalin affects principally the heart, 
the blood vessels, the involuntary muscles, the pupils and 
secretory glands. 

Action on the heart: The effect of adrenalin on the heart, 
is similar to that of digitalis. Adrenalin makes the heart beat 
stronger and slower. 

The heart beats stronger, because the heart muscle is 
made to contract more vigorously. The systole, or con- 
traction of the heart is greater, and the heart therefore expels 
more blood with each contraction. 

It beats slower, because of the increased number of im- 
pulses sent to the heart from the medulla of the brain, along 
the Vagus, or inhibitory nerves, to the heart. These impulses 
make the heart beat slower. Since the heart beats slower, 
it has more time to dilate between each contraction, so that 
the period of relaxation or diastole of the heart, is increased. 
More blood then enters the heart during this period of re- 
laxation, to be expelled by the succeeding greater contrac- 
tion. 

Action on the blood vessels: The most important action 
of adrenalin, is upon the small blood vessels. It contracts 
the small involuntary muscle fibers in the walls of the small 



188 MATERIA MEDICA 

blood vessels. This makes these blood vessels narrower, 
which then helps to increase the pressure of the blood in 
the vessels (blood pressure). At the same time, the nar- 
rower vessels offer a greater resistance for the heart to 
overcome. It therefore also makes the heart beat stronger; 
increasing the strength of its contractions, or systoles. 

The blood vessels in the abdomen are contracted most of 
all, while those in the lungs and brain are contracted least. 

The total effect of adrenalin on the circulation is, therefore; 

Slow, strong contractions of the heart with greatly in- 
creased blood pressure, which make the pulse slow, strong, 
and very tense. 

Action on involuntary muscles: Adrenalin increases the 
contractions of the involuntary muscles of the uterus. Its 
blood vessels also are contracted, making it very anaemic. 

The involuntary muscles of the stomach and intestines are 
relaxed; though the blood vessels in their walls are con- 
tracted. Action on the Pupil: The pupil of the eye is widened 
(dilated) by contraction of the radial fibers of the iris, or 
colored part of the eye. 

Action on the secretory glands: The secretions of all the 
secretory glands, except the sweat glands and the pancreas, 
are increased by adrenalin. This effect is produced by mak- 
ing the nerve endings in the glands more sensitive to stimuli. 
As a result of this action, they receive more impulses, which 
make the glands secrete more profusely. 

The salivary glands, the mucous glands in the mouth and 
throat, the lachrymal glands, and the liver, all secrete more 
profusely after adrenalin. It therefore increases the flow 
of saliva, mucous in the mouth, the flow of tears and bile. 

The secretion of the sweat and pancreatic juice is not in- 
creased by adrenalin. 

It often causes sugar in the urine (glycosuria). The effect 
of adrenalin wears off very quickly; usually in about 15 min- 
utes to an hour. 

Excretion 

Adrenalin is mostly destroyed in the body. Part of it, 
however, is ehminated by the kidney in about an hour or two. 



BLOOD AND CIRCULATORY STIMULANTS 189 

Poisonous Effects 

Overdoses of adrenalin, cause the following symptoms: 

1. Slow irregular pulse. 

2. Pale, blanched skin. 

3. Dilated pupils. 
Still larger doses cause, 

1. Rapid weak thready pulse. 

2. Collapse: Pale cold moist skin, slow and shallow 

breathing, and dilated pupils. 
A single overdose may cause such profound collapse, 
that death may result. 

Uses 

Adrenalin is used: 

1. To check bleeding by contracting the bleeding vessels. 

It is only of value in bleeding from the small blood 
vessels. The bleeding may start up again, however, 
when the effect of the adrenalin wears off, because 
after the blood vessels are contracted, they soon 
dilate again. 
In bleeding from the nose, the stomach, intestines, uterus 

and bladder, adrenalin is very valuable, if applied to the 

bleeding spot. 

2. As a heart stimulant, especially where a rapid effect 

is desired. The effect soon wears off however. 

3. Adrenalin is often used together with cocaine. The 

adrenalin, by contracting the blood vessels, lessens 
the absorption of the cocaine, which is then less apt 
to cause poisonous effects. 

4. In the treatment of Addison's disease (tuberculosis 

or cancer of the adrenal glands). It then supplies 
the absent secretion of the adrenal glands. 

Preparations 

Dried Suprarenal Glands 0.25 gm. grs. iv 

(Glandulae Suprarenales Siccae) 

The powdered dried suprarenal glands of the sheep or ox. 

Adrenalin Chloride Solution 0.3-1.0 c.c. m. v-xv 



190 MATERIA MEDICA 

This is a 1-1000 solution of adrenalin chloride, the active 
principle of the suprarenal glands, in normal salt solution. 

Adrenalin Inhalant 

This is a 1-1000 solution of adrenalin chloride in oil. 
Adrenalin Ointment 

An ointment of adrenalin chloride 1-1000 in strength. 
Adrenalin Suppositories 

A 1-1000 solution of adrenalin chloride in cocoa butter. 
Adrenalin Tablets 

Each tablet contains 0.001 gm. (gr. ?f<r) of adrenalin 
borate. Each tablet when dissolved in 1.0 c.c. (m. xv) of 
water, makes a 1-1000 solution. 

Adrenalin is the name given to the active principle of the 
suprarenal glands by one particular firm that has had this 
name patented. There are other preparations of adrenalin, 
made by other firms under various names, such as: 

Epinephrine. 

Adnephrin. 

Suprarenalin. 

Suprarenin. 

Supracapsulin. 

The preparations of these are the same as those of adre- 
nalin. L. Suprarenin Synthetic is an artificial prepara- 
tion of adrenalin. 

Administration 

Adrenalin is given intravenously, intramuscularly, or 
hypodermically. When it is given intravenously, it must be 
injected very slowly, to avoid poisonous effects. 

For local effect, it is used in 1-15000 to 1-1000 solutions, 
preferably in oil. 



BLOOD AND CIRCULATORY STIMULANTS 191 



Table of Cabdiac Stimulants 



Drugs acting 
rapidly. Suit- 


Drugs acting 
slowly. Suit- 


Drugs causing 


Drugs caus- 
ing a slow 
pulse. 


Drugs whose 
effects wear 


able for imme- 
diate effect. 


able for con- 
tinous effect. 


a rapid pulse. 


off quickly. 


Caffeine 


Digitalis 


Caffeine 


Digitalis 


Caffeine 


Strychnine 


Strophantus 


Atropine 


Strychnine 


Adrenalin 


Atropine 


Squills 


Ammonium 


Adrenalin 


Ammonium 


Camphor 


Convallaria 


Alcohol 


Camphor 


Alcohol 


Adrenalin 


Apocynum 


Camphor 


(some- 


Musk 


Ammonium 


Adonis Ver- 


(sometimes) 


times) 




Alcohol 


nalis 


Musk 


Strophantus 




Digalen 






Squills 




Digipuratum 






Convallaria 




(ampoules) 






Apocynum 




Musk 






Adonis Ver- 
nalis 





CHAPTER IX 
DRUGS ACTING ON THE RESPIRATORY ORGANS 

RESPIRATORY STIMULANTS 

THE RESPIRATION 

Breathing is an act whereby the lungs regularly inhale 
and exhale air about 18-20 times a minute. 

The mechanism of breathing consists of rhythmical alter- 
nate expansions and contractions of the lungs. 

Respiration consists of two phases. 

1. Inspiration. 

2. Expiration. 

The inspiration is the period during which the lung inhales 
air. It is caused by the downward movement of the dia- 
phragm, and the separation of the ribs. This makes the 
chest larger, so that the lungs expand and inhale air. 

The inspired air contains oxygen which fills up the air 
sacs of the lungs. The oxygen then enters the blood, by 
passing through the walls of the air sacs into the capillaries of 
the lungs. It is then carried to the tissues and organs of the 
body by the circulation of the blood. 

The expiration is the period when the lungs exhale air. 
This is caused by the contraction of the diaphragm, which 
then moves upward, and the contractions of the intercostal 
muscles (the small muscles between the ribs). 

As a result of the contractions of these muscles, the chest 
becomes narrower, the lungs therefore contract and expel 
the air which they contain. 

The expired air contains carbon dioxide gas, and other 
waste products which have been brought to the lungs by the 
impure blood from the various tissues and organs of the body. 

Breathing is an automatic act; that is, it occurs inde- 

192 



RESPIRATORY STIMULANTS 193 

pendently of all the influences produced by the other activ- 
ities of the body. 

The most important part of the act of breathing, is the 
action of the diaphragm, a fiat dome-shaped muscle sepa- 
rating the chest from the abdomen. The contractions of this 
muscle are controlled by impulses sent from a spot of gray 
matter in the medulla of the brain, along two nerves which 
go to this muscle, called the Phrenic nerves. This spot of 
gray matter is called the respiratory center. It is often 
called the vital center, because, when it ceases to send im- 
pulses for breathing, the patient dies. 

Death by hanging, or by the garotte (a method for 
execution of criminals in Spain), is caused by the destruction 
of the respiratory center in the medulla of the brain. 

The breathing can be modified, however, by impulses 
reaching the respiratory center along various nerves. 

Impulses affecting the larynx or the bronchi, may reach 
the respiratory center of the medulla, along the Vagus or 
inhibitory nerves (which also send fibers to the larynx, 
bronchi and lungs). 

These impulses may cause the respiratory center to send 
impulses which may increase the depth and frequency of 
breathing (reflex action). Impulses reaching this center 
from the skin, such as those produced by cold air, cold water, 
etc., also increase the depth and frequency of breathing. 

Dyspnoea 

When it is difficult for the patient to get air into his lungs, 
for example, when there is an obstruction to breathing; all 
the muscles attached to the chest, from the arms, neck and 
abdomen, contract. This makes the chest very much 
larger. The lungs therefore expand more than usual, so 
that the inspiration is very much deeper. 

The contractions of the diaphragm and intercostal muscles, 
are also greater; thereby making the chest much smaller 
with each expiration, so that more air is exhaled. 

Such difficult breathing is called dyspnoea. 

It is often caused when there is no obstruction to breath- 
ing, but when the blood is very impure, and contains a great 



194 MATERIA MEDICA 

deal of carbon dioxide gas. This increases the impulses 
for breathing sent out from the medulla of the brain, thereby 
making the breathing deeper and more labored. 

Apnoea 

When the breathing is so slow and shallow that the move- 
ments of the chest can hardly be seen, it is called apnoea. 

Cyanosis 

Cyanosis is a blue color of the skin. This is caused by the 
dark color of the blood in the superficial blood vessels. This 
dark color is due to the carbon dioxide and other waste 
matters which the blood contains. It usually results when 
the patient does not get enough oxygen into the lungs to 
purify the blood. 

Coughing 

Coughing is a violent expiration preceded by a deep in- 
spiration. When a patient coughs, there is first a deep in- 
spiration, followed by violent contractions of the abdominal 
muscles, which push the abdominal organs up against the 
diaphragm. The diaphragm then presses up against the 
lungs, and violently expels the air and secretions which they 
contain. The expiration is violent, because at the time when 
the expiration occurs, the larnyx is closed. 

Coughing is a reflex act. It occurs when an object lodges 
in the larynx, when the bronchi are red and inflamed, or 
when they contain a great deal of secretion. These affect 
the nerve endings in the bronchi, which send impulses along 
the Vagus nerves to the respiratory center in the medulla. 
This center at once sends back impulses to cause violent ex- 
piratory contractions of the diaphragm, and coughing results. 

Drugs affect the respiration in two ways. 

1. Increasing the breathing: Stimulation. 

2. Lessening the breathing: Depression. 

Respiratory stimulation 

When the respiration is stimulated, the breathing is 
usually deeper and faster. More air, and therefore more 
oxygen enters the lungs and then the blood. 



RESPIRATORY STIMULANTS 195 

Respiratory stimulation is produced in several ways. 

1. By sending more impulses for breathing from the res- 
piratory center of the medulla of the brain. 

2. By causing redness, swelling and profuse secretion (ir- 
ritation) of the mucous membrane of the bronchi, impulses 
are sent along the Vagus nerves to the respiratory center 
of the medulla. This center at once sends back impulses 
to make the breathing deeper and faster (reflex action). 

3. By improving the condition of the blood, the medulla 
is supplied with better and purer nourishment. It is there- 
fore better able to send out more impulses for breathing. 
The breathing is then deeper and faster. Tonics such as 
iron, often increase the breathing in this way. 

RESPIRATORY STIMULANTS 

The following drugs are used as respiratory stimulants. 
They make the breathing deeper and faster. They produce 
this effect by increasing the action of the respiratory center, 
so that more impulses for breathing are sent out from this 
center. 

Their general action has already been considered, or will 
be considered later. 

Respiratory Stimulants 

Atropine 

Caffeine 

Camphor 

Strychnine 

Alcohol 

Ammonia 

They are principally used in the treatment of collapse. 
Atropine is the best known respiratory stimulant. 
Strychnine is often used to increase coughing. 
Ammonia is given by inhalation, usually in fainting. 

ASPIDOSPERMA OR QUEBRACHO (not official) 

Aspidosperma or quebracho, is obtained from the bark of 
the Aspidosperma quebracho bianco, a South American tree. 



196 MATERIA MEDICA 

Its active principles are six alkaloids; 
Aspidosp ermine 
Aspidospermatine 
Aspidosamine 
Quebrachine 
Hypoquebrachine 
Quebracharaine 

ACTION 

Local action: On the skin, it produces no effect. On 
mucous membranes : It causes redness and profuse secretion 
of mucus. 

Internal Action 

In the mouth : It has a bitter taste and it increases the flow 
of saliva. 

In the stomach : It increases the secretion of mucous mem- 
brane of the stomach, and causes nausea and vomiting. 

In the intestines : It increases the secretion of mucous mem- 
brane often causing diarrhoea. 

Action after Absorption 

Aspidosperma is absorbed from the stomach, and affects 
principally the respiration, the mucous membranes, and 
slightly the heart. 

Action on the respiration: Aspidosperma makes the breathing 
deeper and quicker. It causes more impulses for breathing 
to be sent out, from the respiratory center of the medulla. 

Action on mucous membranes: The secretions of all the 
mucous membranes are increased; especially the secretion of 
mucous membrane of the bronchi. This increases the ex- 
pectoration. 

The effect on the mucous membranes results from its action 
on the vomiting center in the medulla of the brain. It causes 
the center to send out more impulses for vomiting. Such 
vomiting is always accompanied by increased secretions of 
all the mucous membranes; tears, nasal secretions, saliva, etc. 

Action on the heart: The contractions of the heart 
muscle are weakened by aspidosperma. The pulse may be 
rapid or slow, but the blood pressure is always lowered. 



RESPIRATORY STIMULANTS 197 

Action on the kidney: The secretion of urine is often in- 
creased. 

Excretion 

Aspidosperma is eliminated from the body by the kidneys 
and intestines; and when the vomiting is severe, in the 
vomited matter. 

Poisonous Effects 

Overdoses of aspidosperma cause the following symptoms. 

1. Nausea and vomiting. 

2. Diarrhoea. 

3. Slow and shallow breathing. 

4. Convulsions and paralyses. 

Uses 

Aspidosperma is used principally to relieve difficult breath- 
ing (dyspnoea), especially in asthma and emphysema. 

Preparations 

Fluidext^act of Aspidosperma 1.0 -4.0 c.c. m. xv-5i 
(Fluidextra r c:tum Aspirospermae) 

Ex^apl^x^s^idosperma 0.08-0.2 gm. grs. i -iii 

(Ex&ajctega ^sjgdospermae) 

AspidDspferbase a» 0.001-0.002 gm. gr. -bVtV 

(a mixture of all the alkaloids) 

OXYGEN 

ijjfiiiao' 
Oxygen is a gajs^which forms 20% of ordinary air, and is 

necessary for the4i%$f all animals. It is inhaled by the 

lungs with the inspired air. From the lungs, it enters the 

blood and combines with the haemoglobin of the red blood 

cells. These cells carry "the oxygen to the various tissues 

and organs of the body, where it combines with some of the 

constituents of their cells, which are thus enabled to carry 

on their various activities. 

ACTION 

Local action : Oxygen is a very good antiseptic, since most 
bacteria are unable to live in an atmosphere of pure oxygen. 



198 MATERIA MEDICA 



Internal Action 



When pure oxygen gas is inhaled, it enters the plasma of 
the blood, from the air sacs of the lungs. Some of the oxygen 
combines with the haemoglobin, forming oxyhaemoglobin, 
while part of it circulates uncombined, in the plasma. The 
formation of a greater amount of haemoglobin, gives the 
blood a brighter color, and the skin then turns a brighter 
red color. 

The improved condition of the blood makes the breathing 
slower, and slows and strengthens the heart action. 

Uses 

Oxygen is used in Pneumonia, when the patient is blue 
and cyanotic, because he is not able to get enough oxygen 
in his blood, because part of the lung is consolidated. The 
oxygen inhalations often relieve this blue color, and make 
the breathing easier. 

Oxygen is also given in potassium chlorate, and illuminating 
gas poisoning, because these drugs combine with the haemo- 
globin of the blood, and prevent it from taking up oxygen 
from the lungs. The oxygen which is inhaled in these cases, 
enters the plasma in sufficient quantity to supply the tissues 
with nourishment until the haemoglobin is freed from the 
poisonous substance. 

Administration 

Oxygen should always be given continuously; inhaled 
through a mask from a tank alongside of the bed. The in- 
halations should be stopped when the symptoms disappear. 

STIMULATING EXPECTORANTS 

The following drugs are used principally for their effects 
on the lungs. 

They are used to increase the expectoration and the cough- 
ing (violent expiration). This effect is produced by the 
profuse secretion of the mucous membrane of the bronchi 
which these drugs cause. 

The excessive secretions of the bronchi, affect their nerve 



RESPIRATORY STIMULANTS 199 

endings, thereby sending impulses along the Vagus nerves 
to the respiratory center in the medulla. This center at 
once sends back impulses to markedly increase the breath- 
ing, which then cause violent expiratory effects or coughing 
(reflex action). 

AMMONIUM CHLORIDE (AMMONH CHLORIDUM) 

Ammonium chloride is an alkaline salt formed by the com- 
bination of ammonia and hydrochloric acid. 

Appearance of the Patient 

When ammonium chloride is given, the cough and expec- 
toration is increased. The expectoration is more fluid in 
character. The pulse is somewhat stronger and more rapid, 
and the breathing is deeper. 

ACTION 

Local action: Applied to the skin, ammonium chloride is 
more soothing than other ammonia preparations. It makes 
the skin feel cool and lessens inflammation. On mucous 
membranes : It increases the secretions, and slightly increases 
the growth and nutrition of the cells of the mucous mem- 
brane. 

Internal Action 

In the mouth : It has an unpleasant nauseating taste. In 
large doses it often causes nausea and vomiting. 

In the intestines : It increases the secretion of the mucous 
membrane, often causing frequent movements of the bowels. 

Action after Absorption 

Ammonium chloride is absorbed rapidly from the stomach. 
After absorption it affects principally the mucous membrane 
of the bronchi and other mucous membranes, and slightly, 
the liver, sweat glands and kidney. 

Action on the lungs: Ammonium chloride increases the 
secretion of the mucous membrane of the bronchi, and makes 
the secretion more fluid in character. 



200 MATERIA MEDICA 

The increased secretions also affect the nerve endings in 
the bronchi, so that impulses are sent to the respiratory 
center in the medulla. The center then sends back more 
impulses to cause violent expiratory efforts, and the cough 
is therefore increased by this reflex action. The secretions, 
becoming more fluid, are also more easily expectorated. 

Action on the respiration: Ammonium chloride makes the 
breathing deeper and faster, not only by the reflex action 
from the lungs, but also by directly acting on the respiratory 
center itself. 

Action on the secretory glands: The secretion of all the 
mucous membranes such as those of the stomach and intes- 
tines, are increased by ammonium chloride. 

The secretion of the sweat, the saliva, and the bile are 
also increased. 

Action on the heart: In large doses ammonium chloride 
makes the heart beat stronger and faster. The pulse is there- 
fore stronger and faster. 

Action on the kidney: Ammonium chloride increases the 
flow of urine. 

Excretion 

Ammonium chloride is partly changed to urea, a normal 
constituent of the urine. It is excreted by the kidney, 
partly as ammonium chloride, and as urea. 

Poisonous Effects 

Overdoses of ammonium chloride cause: 

1. Nausea and vomiting. 

2. Diarrhoea. 

3. Bleeding from the mucous membranes. 

4. Profound collapse. 

Uses 

Ammonium chloride is used to increase expectoration 
and coughing. 

Preparations 

Ammonium Chloride 0.3-1.0 gm. grs. v-xv 

(Amonii Chloridum) 



RESPIRATORY STIMULANTS 201 

Troches of Ammonium Chloride 
(Trochisci Amonii Chloridi) 

Each contains about 0.1 gm. (grs. ii) of ammonium 
chloride with 0.25 gm. (grs. iv) of licorice extract, and some 
syrup of tolu. 

Liquor Amonii Anisatus (Solution of Ammonia and Anise) 

This is a German preparation consisting of 



Oil of anise 


1 part 


Ammonia water 


5 parts 


Alcohol 


24 parts 



It is not official in this country, but it is extensively used, 
and is a very valuable preparation. It is an excellent 
stimulating expectorant and is given in doses of 0.6 to 
2.0 gms. (m. x-xxx). 

SENEGA (SNAKE ROOT) 

Senega is obtained from the root of the Polygala senega, 
or senega snake root; a plant growing in the middle and 
southern United States. 

The active principles are a special kind of glucosides 
called saponins, because they form soapy or frothy solutions, 
(digitonin, one of the inactive principles of digitalis is such 
a substance). The saponins found in senega are senegin 
and polygalic acid. 

Appearance of the Patient 

When any of the preparations of senega are given, the 
cough and expectoration are increased, and the patient has 
more frequent movements of the bowels. 

ACTION 

Local action: Applied locally senega is injurious to the 
tissues, because of the saponins which it contains. On the 
skin, it causes redness, warmth and itching, often causing 
pustules. On the mucous membrane: it causes marked 



202 MATERIA MEDICA 

redness, swelling, and profuse secretion of mucus. For 
example — in the nose, it causes marked redness, sneezing, 
with profuse secretion of mucus. Redness of the conjunctiva 
with swelling and profuse secretion of tears and mucus, is 
often caused when it is applied locally to the eye. It may 
even cause inflammation when locally applied. 

Internal Action 

In the mouth: It has a harsh unpleasant taste, it causes 
redness and swelling of the lining membrane of the mouth 
with excessive secretion of saliva. 

In the stomach: It causes marked redness, swelling and 
profuse secretion of the mucous membrane, which often 
results in nausea and vomiting. 

In the intestines : The same effects on the mucous membrane 
cause frequent movements of the bowels. 

Action after Absorption 

On account of the nausea and vomiting which it produces, 
senega is not readily absorbed; part of it being excreted in 
the vomited matter. 

When it is absorbed, it affects principally the mucous 
membrane of the bronchi, other mucous membranes and 
slightly the sweat glands and kidney. 

Action on the lungs: Senega increases the secretion of 
the mucous membrane of the bronchi. The redness and 
swelling of the mucous membranes, which it also produces, 
reflexly cause increased coughing. 

Action on the secretory glands: It increases the secretion 
of sweat and it also slightly increases the flow of urine. 

Senega is said to increase the menstruation. 

Poisonous Effects 

Overdoses of senega cause, 

1. Nausea and vomiting. 

2. Profuse diarrhoea. 

3. Collapse; rapid, weak thready pulse, slow shallow 
breathing, pale, cold moist skin, and dilated pupils. 



RESPIRATORY STIMULANTS 203 

Uses 

Senega is not a very reliable drug. It is used principally 
as a stimulating expectorant and somewhat as a diuretic. 

Preparations 

Fluidextract of Senega 0.6-1.0 c.c. m. x-xv 

(Fluidextractum Senegae) 

Syrup of Senega 4.0-8.0 c.c. 5i-ii 

(Syrupus Senegae) 

Senega is also contained in the compound syrup of squills. 

QUILLAJA (SOAP BARK) 

Quillaja, panama bark, or soap bark, is obtained from 
the inner bark of the Quillaja saponaria, a South American 
tree growing principally in Chili. 

Its active principles are saponins (soapy or frothy gluco- 
sides) called, quillaja sapotoxin, and quillajic acid. 

ACTION 

Local action: Applied to the skin, it is very injurious. 
It causes redness, swelling and severe inflammation. On 
mucous membranes : It has the same effects and causes pro- 
fuse secretion. 

Internal Action 

In the mouth : It has a harsh unpleasant taste. It inflames 
the mucous membrane. 

In the stomach: It causes redness and swelling of the 
mucous membrane, producing in this way, nausea and 
vomiting. 

In the intestines : It produces the same effect on the mucous 
membrane, which results in frequent movements of the 
bowels. 

Action after Absorption 

Quillaja is absorbed in the stomach. 

After absorption, it affects principally the mucous mem- 
branes; especially the mucous membranes of the lungs. 



204 MATERIA MEDICA 

Action on the lungs: Quillaja increases the secretion of 
the mucous membrane of the bronchi. In this way it also 
reflexly increases the cough. 

Poisonous Effects 

On account of the saponins which quillaja contains, large 
doses cause: 

1. Nausea and vomiting. 

2. Diarrhoea. 

3. Collapse. 

Large doses also paralyze muscles and nerves. Such 
doses weaken the contractions of the heart. Its action on 
the heart is directly antagonistic to that of digitalis. 

Uses 

Quillaja is occasionally used as an expectorant. It is 
used by pharmacists to emulsify (break up into fine globules) 
oils and other oily substances. It is largely used for cleaning 
silk and other fabrics. 

Preparations 

Fluidextract of Quillaja 0.2 c.c. m. iii 

(Fluidextractum Quillajae) 

Tincture of Quillaja 2.0-4.0 c.c. 5^-i 

(Tinctura Quillajae) 

SAPONINS AND SAPOTOXINS 

Saponins and Sapotoxins are a species of glucosides, which 
have the property of forming soapy or frothy solutions. 
They are thus able to hold substances which cannot be 
dissolved, suspended in finely divided particles in a fluid. 

The more poisonous ones are called sapotoxins; the less 
poisonous ones saponins. 

Senega and quillaja produce their effects because of the 
saponins which they contain. 

ACTION 

The saponins and sapotoxins are poisonous to all living 
tissues (protoplasm) by causing such markedly increased 






RESPIRATORY STIMULANTS 205 

activity, as to injure the tissues. Large doses of saponins 
or sapotoxins, or plants containing such giucosides, cause: 

1. Violent vomiting. 

2. Profuse diarrhoea. 

3. Painful urination, often bloody urine. 

4. Convulsions. 

5. Often these glucosides cause destruction of the red 
blood corpuscles, so that the haemoglobin is set free in the 
serum (laking of the blood). 

6. Collapse. 

Saponins and sapotoxins are contained in about 150 
kinds of plants. The most important ones are: 

Polygala senega. 

Quillaja saponaria. 

Various kinds of smilax, such as sarsaparilla. 

Agrostemma githago or corncockle. 

Gypsophila struthium. 

Of these, the only ones used in medicine to any extent 
are, senega, quillaja, and sarsaparilla. Senega and quillaja 
are used as expectorants and have already been described. 

Sarsaparilla is used to improve the nutrition of the tis- 
sues and will be described later. 

TEREBENUM (TEREBENE) 

Terebene is a liquid formed from the oil of turpentine 
when it is acted upon by sulphuric acid. 

The effects of terebene are similar to those of turpentine. 

ACTION 

Local action: Applied to the skin or mucous membranes, 
it causes redness and is somewhat antiseptic. 

Internal Action 

In the mouth : It has a rather pleasant odor and taste, and 
reddens the mucous membrane. 

In the stomach and intestines: It acts as an antiseptic, 
and carminative. It checks the formation, and hastens the 
expulsion of gas. 



206 MATERIA MEDICA 

Action after Absorption 

Terebene is rapidly absorbed from the stomach. After 
absorption it affects principally the lungs and kidneys. 

Action on the lungs: In the lungs it acts as an antiseptic. 
It is often inhaled for its antiseptic effect. It increases the 
secretion of mucus, thereby increasing expectoration and 
reflexly increasing coughing. 

Action on the kidneys: Terebene increases the flow of 
urine (diuretic). It often relieves neuralgic pains. 

It is excreted mainly by the urine. 

Uses 

Terebene is used principally as a stimulating expectorant. 
It is also used to expel gas from the stomach and intestines 
and as an antiseptic in inflammations of the kidneys and 
bladder. 



Preparations 

Terebene 0.3-2.0 c.c. 

(Terebenum) 



m. v-xxx 



TERPIN HYDRATE 

Terpin hydrate is a colorless crystalline substance made 
from the oil of turpentine, by the action of nitric acid, 
alcohol and water. 

Its action is similar to that of turpentine. 

ACTION 

Local action: Applied to the skin or mucous membranes, it 

causes redness. 

Internal Action 

In the mouth: It has an aromatic bitter taste. 

In the stomach and intestines : It acts as an antiseptic and 
carminative. It checks the formation, and hastens the ex- 
pulsion of gas. 

Action after Absorption 
Terpin hydrate is rapidly absorbed. It affects the mucous 



RESPIRATORY STIMULANTS 207 

membranes, especially the mucous membrane of the bronchi, 
and it also affects the kidneys. 

Action on mucous membranes: It reddens and increases 
the secretions of all mucous membranes. 

Action on the lungs: Terpin hydrate increases the se- 
cretions of the mucous membrane of the bronchi. In this 
way, it reflexly increases coughing. Expectoration is in- 
creased, because of the increased cough; and the secretions are 
looser. 

Action on the kidney: It increases the flow of urine 
(diuretic action). 

Terpin hydrate, like turpentine, often relieves neuralgic 
pains. 

Excretion 

It is excreted mainly by the kidney. 

Uses 

Terpin hydrate is used principally as a stimulating ex- 
pectorant, as an antiseptic in gonorrhoea, and in cystitis 
(inflammation of the bladder). 

Preparations 

Terpin Hydrate 0.06-0.2 gm. grs. i-iii 

(Terpini Hydras) 

BALSAM OF PERU (BALSAMUM PERUVIANUM) 

Balsam of Peru is a dark brown syrupy fluid, which does 
not dissolve in water. It is a balsam which oozes from the 
trunk of the Toluifera pereirae, a tree growing in Central 
America. (A balsam is an aromatic fluid, or semi-solid sub- 
stance which exudes from a plant; for example, the sap of a 
tree is a balsam. Balsams consist of a volatile oil, a resin, 
benzoic and cinnamic acids.) 

ACTION 

Local action: Applied to the skin, it is somewhat antiseptic 
and soothing. On wounds and ulcers it hastens the heal- 



208 MATERIA MEDICA 

ing by increasing the formation of new cells. On mucous 
membranes : It causes slight redness and it increases the secre- 
tions. 

Internal Action 

In the mouth : It has a warm bitter taste. 

In the stomach and intestines: It increases the secretion 
of the mucous membrane; it is slightly antiseptic, and checks 
the formation and aids the expulsion of gas. (Carminative 
action.) 

Action after Absorption 

After absorption, it affects principally the mucous mem- 
brane of the bronchi, and slightly the heart and kidney. 

Action on the lungs: Balsam of Peru increases the secre- 
tion of the mucous membrane of the bronchi, thereby aiding 
expectoration. The excessive secretion also reflexly increases 
the cough. 

Action on the heart: The heart beats somewhat faster 
and stronger, so that the pulse is somewhat faster and 
stronger. This action is very slight, however. 

Action on the kidneys: On account of the benzoic acid 
which the balsam contains, it slightly increases the flow of 
urine. 

Excretion 

Balsam of Peru is excreted rapidly by the kidneys. 

Uses 

Balsam of Peru is used principally to increase the growth 
of granulation tissue (young scar tissue). It is occasionally 
used as a stimulating expectorant. 

Preparations 

Balsam of Peru 0.3-1.0 c.c. m. v-xv 

(Balsamum Peruvianum) 

BALSAM OF TOLU (BALSAMUM TOLUTANUM) 

Balsam of tolu is a reddish yellow sticky semi-solid sub- 
stance, which dissolves in alcohol, but not in water. 



RESPIRATORY STIMULANTS 209 

It is a balsam obtained from the sap of the bark of the 
Toluif era balsamum, or Myroxylon toluifera, a Central Ameri- 
can tree closely related to the tree from which the balsam of 
Peru is obtained. 

The composition of both the balsam of tolu and the 
balsam of Peru is the same, except that the balsam of tolu 
contains more benzoic acid. 

ACTION 

The effects are similar to those produced by the balsam 
of Peru. Its odor, however, is very fragrant and it tastes 
like vanilla. For this reason, the balsam of tolu is preferred 
for internal use. 

Uses 

It is principally used as a stimulating expectorant usually 
combined with other expectorants. Its action, however, 
is not very marked, its use being principally that of a flavor- 
ing agent. 

Preparations 

Balsam of Tolu 0.3-1.0 gm. grs. v-xv 

(Balsamum Tolutanum) 

Syrup of Tolu 2.0-4.0 c.c. 3H 

(Syrupus Tolutanus) 

Tincture of Tolu 1.0-4.0 c.c. m. xv-5i 

(Tinctura Tolutana) 

Balsam of tolu is also contained in the compound tincture 
of benzoin. 

TAR (PIX LIQUIDA) 

Tar is a black semi-solid sticky substance of a peculiar 
characteristic odor and taste. It is an oleoresin. It is ob- 
tained by the destructive distillation of the wood of various 
species of the pine tree. The Pinus palustris or the pine tree 
of North Carolina is principally used. (Destructive distilla- 
tion is a process of decomposition by heating. Some of the 
decomposed products are vapors, and become fluid or semi- 
solid when received in a cold receptacle.) 



210 MATERIA MEDICA 

When tar is distilled, it forms the oil of tar, an oily liquid 
and a solid black residue called pitch. 

Tar consists of a number of substances; the most impor- 
tant ones are: creosote, pyroligneous acid, wood alcohol, 
and a number of other compounds of carbon and hydrogen 
(hydrocarbons). 

ACTION 

Local action: Applied to the skin, tar is an antiseptic, 
and causes redness and slight swelling (mild irritation). 
On mucous membranes: It has an antiseptic action, causes 
redness and increases the secretion of mucus. 

Internal Action 

In the mouth: It has a peculiar, though not unpleasant 
taste and odor. 

In the stomach : Tar causes redness, and profuse secretion 
of the mucous membrane, often causing nausea and vomiting. 

In the intestines: It causes redness and profuse secretion 
of the mucous membrane; often causing frequent move- 
ments of the bowels. It is an antiseptic in the intestines 
and it often destroys worms. 

Action after Absorption 

Tar is absorbed from the stomach. After absorption it 
affects principally the lungs and the kidneys. 

Action on the lungs: It increases the secretion of the 
mucous membrane of the bronchi, and in this way it reflexly 
increases the cough slightly. It is also an antiseptic in 
the lungs. 

Action on the kidneys: Tar slightly increases the flow of 
urine. 

Excretion 

Tar is excreted mainly by the kidneys and intestines. 
It turns the urine and stools a very dark color. 

Uses 

Locally it is used in chronic skin diseases, especially in 
chronic eczema. 



RESPIRATORY STIMULANTS 211 

Internally it is principally used as a stimulating expecto- 
rant, especially in chronic bronchitis. It is occasionally used 
to destroy intestinal worms, and as an intestinal antiseptic. 

Preparations 

Oil of Tar 0.06-0.3 c.c. m. i-v 

(Oleum Picis Liquidae) 

Syrup of Tar 4.0-12.0 c.c, 3i— iii 

(Syrupus Picis Liquidae) 

This contains 74% of tar. 

Tar Ointment 
(Unguentum Picis Liquidae) 

This contains 50% of tar. 

ALLIUM (GARLIC) (not official) 

Allium or garlic, is the bulb of Allium sativum or garlic 
plant. Its active principle is a volatile oil; the oil of garlic. 

ACTION 

Local action: Applied to the skin, it causes marked red- 
ness. On mucous membranes : It causes redness and profuse 
secretion. 

Internal Action 

In the mouth: It has a pungent, rather unpleasant taste 
and odor and it increases the flow of saliva. 

In the stomach: It increases the secretion of gastric juice 
and aids digestion. In the intestines: The secretion of the 
mucous membrane is increased. 

Action after Absorption 

Allium is absorbed in the stomach, and affects principally 
the lungs, the mucous membranes, and slightly the heart. 

Action on the lungs: In the lungs allium increases the 
secretion of the mucous membrane of the bronchi and air 
sacs; thereby also reflexly increasing the cough. It is said 
to increase the expulsive power of the very fine bronchioles. 



212 MATERIA MEDICA 

Action on the mucous membranes: The secretions of all 
mucous membranes are increased by allium. 

Action on the heart: It slightly increases the heart action. 

Excretion 
It is excreted mainly by the kidneys and the intestines. 

Uses 

Allium is used as a local application to cause redness of 
the chest, thereby withdrawing blood from deeper tissues 
(counter irritant). It is used for this purpose, especially 
in convulsions in children. 

The garlic is chopped into fine pieces, and applied as a 
poultice. For infants, its strength is weakened with flaxseed 
meal. 

Internally it is used as a stimulating expectorant in 
chronic bronchitis. It is given especially to children. 

Preparations 

Syrup of Garlic 4.0 c.c. 5i (for a child) 

(Syrupus Allii) 

SANGUINARIA (BLOOD ROOT) 

Sanguinaria or blood root is obtained from the under- 
ground stems of the Sanguinaria canadensis, gathered in the 
autumn when its leaves are dead. Its active principle is an 
alkaloid sanguinarine. It was formerly used extensively as a 
stimulating expectorant, but it has now mostly been given 
up. 

ACTION 

Local action: Applied to the skin, sanguinaria relieves 
pain. On mucous membranes : It increases the secretion. 

Internal Action 

In the mouth : It increases the flow of saliva. 

In the stomach and intestines: It greatly increases the 
secretion, causing vomiting, profuse diarrhoea with violent 
peristalsis. 



RESPIRATORY STIMULANTS 213 

Action after Absorption 

After absorption, sanguinaria increases all the secretions; 
especially the secretion of the mucous membrane of the 
bronchi, the saliva and the flow of bile. 

It also slows the pulse and it increases the blood pressure. 

Poisonous Effects 

Overdoses cause the following symptoms: 

1. Violent vomiting. 

2. Diarrhoea. 

3. Great weakness. 

4. Slow irregular pulse with low blood pressure. 

5. Dilated pupils. 

6. Collapse. 

7. Convulsions; usually just preceding death. 

Preparations 

Tincture of Sanguinaria 1.0-2.0 c.c. m. xv-xxx 

(Tinctura Sanguinariae) 

Fluidextract of Sanguinaria 0.1-0.5 c.c. m. ii -viii 

(Fluidextractum Sanguinariae) 

ERIODICTYON (YERBA SANTA) 

Eriodictyon is obtained from the leaves of the Eriodictyon 
californicum, or the California tar bush. 

It is occasionally used as a stimulating expectorant in 
chronic bronchitis. 

It lessens the appreciation of bitter tasting substances. 
It is often used as a vehicle in the form of an elixir, to dis- 
guise the taste of bitter drugs such as quinine. 

Preparations 

Fluidextract of Yerba Santa 1.0-4.0 c.c. m. xv-5i 

(Fluidextractum Eriodycti) 

APOCODEIN HYDROCHLORIDE 

(Not official) 0.06 gm. gr. i 

This is frequently used as an expectorant. 



214 MATERIA MEDICA 

The following drugs are also frequently used as expector- 
ants. Their action has already been considered, or will be 
considered later. 

Squills 

Benzoin 

Eucalyptus 

Turpentine 

Prunus Virginiana (wild cherry) 

Marrubium (horehound) 

Serpentaria 



CHAPTER X 

DRUGS WHICH STIMULATE THE NERVOUS SYSTEM 

THE NERVOUS SYSTEM 

The nervous system, or the cerebro-spinal system, con- 
sists of a number of organs which regulate the activities of 
all the other organs and tissues of the body. 

The nervous system increases or diminishes the activities 
of the various organs of the body. It harmonizes the actions 
of one organ with those of another, and the activity of the 
body with its surroundings. 

The nervous system consists of the brain, the spinal cord, 
the nerves, and nerve endings. 

The brain 

The brain is an organ situated in the skull. It consists 
of an outer part which has numerous folds, called convolu- 
tions. This outer part is of a gray color and consists of 
numerous microscopic cells. 

The inner part of the brain is white in color, and consists 
of numerous microscopic fibers coming from, or going to, 
the cells in the gray matter. 

The cells of the gray matter are the active parts of the 
brain. 

The brain is divided into three parts: 

1. The Cerebrum 

2. The Cerebellum 

3. The Medulla Oblongata 

The cerebrum forms the largest part of the brain and it 
is often called the fore brain. 

The cerebellum is much smaller than the cerebrum, and 
is situated immediately behind the cerebrum. It is often 
called the hind brain. 

215 



L 



216 MATERIA MEDICA 

The medulla oblongata joins the cerebrum to the spinal 
cord. It is often called the mid brain. 

Action of the Cerebrum 

The cells of the gray matter of the cerebrum do three 
kinds of work. 

1. Sensory 

2. Motor 

3. Mental 

The sensory work of the brain consists of receiving im- 
pulses or messages from the various organs of the body. 

The motor work of the brain is to send out impulses or 
messages to the various organs of the body. 

The mental work of the brain is to associate impulses and 
impressions, received, or sent out by one group of cells of 
the brain with those of another group. 

SENSORY ACTIVITY OF THE BRAIN, OR THE IMPULSES 
OR MESSAGES THAT ARE RECEIVED BY THE BRAIN 

The body is kept constantly aware of its surroundings, 
and objects about it, by the impulses received through its 
various senses. 

There are five kinds of sensory impressions received by 
the brain. These impressions are received through the 
various senses: 

1. Sense of Sight 

2. Sense of Hearing 

3. Sense of Smell 

4. Sense of Taste 

5. Sense of Touch 

Sight 

The impressions received through the sense of sight, are 
received through the eyes, which are complicated organs 
attached to the ends of nerves going to the brain; the optic 
nerves. 

Through the eye the brain learns the character of various 
objects about it, their size, their shape and color. The body 
is thus able to avoid dangerous objects. It is also able to 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 217 

distinguish between light and darkness, and in this way we 
can teli the time of day, etc. 

Hearing 

The impressions of hearing are received through the 
ears, by means of nerves going from the ears to the brain. 
Through the impulses of hearing, the body appreciates 
pleasant and unpleasant sounds. It is able to avoid dangers, 
and to respond to various impressions of sound; such as 
music, etc. 

Smell 

Through the sense of smell the brain is able to appreciate 
pleasant and unpleasant odors by means of nerves going 
from the nose to the brain; the olfactory nerves. Poisonous 
foods can thus be avoided, etc. 

Taste 

Through the sense of taste, pleasant and unpleasant food 
substances are recognized, by means of impulses sent from 
the tongue to the brain along various nerves. The enjoy- 
ment of food is thus helped, and poisonous foods can be 
avoided. 

Touch 

The brain receives impressions through the sense of 
touch by means of numerous nerves which reach it either 
directly or through the spinal cord. The impressions are 
received by numerous nerve endings scattered over every 
part of the skin, and then carried along the various nerves to 
the brain or spinal cord. 

Four different kinds of impressions are received by the 
nerve endings in the skin. Many of these sensations are 
received by special nerve endings, and reach the brain or 
spinal cord by separate nerve fibers. 

1. Sensation of touch: This is a sensation whereby the 
consistency and shape of an object is determined by feeling 
it; whether it is hard, soft, smooth or rough; whether it is 
round, square, etc. 



218 MATERIA MEDICA 

2. Sensation of pain: This is an unpleasant sensation, 
whereby the body is able to avoid injurious objects, and by 
which we are made aware of various diseased conditions, 
such as inflammation, injuries, etc. 

3. Sensations of temperature : This is a sensation whereby 
the brain is able to determine, whether an object is hot or 
cold, by means of impressions received by the brain from 
various nerves coming from special nerve endings in the skin. 

4. Muscular sense: This is an important sensation 
whereby the brain is constantly informed of the position 
of the various joints of the body; such as the joints of the 
extremities. This enables us to walk about, without con- 
tinually watching our steps, or to button our clothes without 
watching this act. In some diseases such as locomotor 
ataxia, where this sense is affected, the patient is unable to 
walk without watching his steps. 

All the impressions received by the brain through the 
various senses are stored up in the cerebrum. When a 
similar impression is received again, it is at once recognized. 
For example — an object or color when seen again, is recog- 
nized as having been seen before, and under which circum- 
stances it was seen. 

MOTOR FUNCTIONS OF THE BRAIN 

The impulses sent out from the brain are principally, 

1. Impulses for Motion 

2. Impulses for Speech 

Impulses for Motion 

Certain areas of the gray matter of the brain contain cells 
which constantly send out impulses to make the muscles con- 
tract, and thereby produce the various movements of the 
body. This part of the brain is called the motor center. 
There are two such centers; one on each side of the brain. 
Each side sends out impulses to cause motion of the opposite 
side of the body, and to regulate the movements of the 
extremities on that side of the body. 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 219 

Impulses for Speech 

There is an area of gray matter in the cerebrum, which 
sends out impulses to cause the complicated movements of 
the muscles of the larynx causing speech. 

The speech center is situated only on one side of the 
brain, usually on the left side, except in left handed individ- 
uals, in whom it is situated on the right side. 

MENTAL ACTIVITIES OF THE BRAIN 

The following activities of the brain are called mental 
activities. They are not due to the action of any particular 
part of the brain, but to the action of a number of areas to- 
gether, or by the action of one part of the brain upon another. 

1. Consciousness 

2. Attention 

3. Memory 

4. Reasoning 

5. Judgment 

6. Emotion 

7. Imagination 

8. Willpower 

Consciousness 

By consciousness, we mean that we are aware of objects 
and persons about us, of the time of the day, of the place 
where we are, etc. 

Consciousness depends upon our sensations; because the 
sensations inform the brain of our surroundings. When the 
sensations are increased, consciousness is increased; when 
they are diminished, consciousness is lessened. For ex- 
ample — morphine, a drug which lessens the appreciation of 
the sensations, produces unconsciousness, or sleep. 

Attention 

Attention is an activity whereby the brain keeps on 
receiving, sending out, and associating impulses only of one 
particular kind, at a certain time; that is, we are conscious 
only of a certain object. For example — when reading a 
certain book, we may have our attention so fixed on it, that 



220 MATERIA MEDICA 

we may not see anyone coming into the room, nor objects 
about us. We may hear what anyone says, but yet not 
really know what was said. 

Memory 

Memory is an act of the brain whereby an old impression 
that has been received or sent out some time ago, either by 
our sensations or by our actions or experiences, is recalled 
again. For instance: We may remember that on a certain 
day we saw a famous parade. The impression of the parade 
is so fixed in our brain that it can easily be recalled. 

Reasoning 

Reasoning is an act of the brain whereby old impressions 
that have been stored up in the brain, either by experience 
or study, or received through our sensations, are combined 
to form a definite conclusion. For example — to find out the 
cost of ten apples when we know the cost of four. We have 
learned that we must first find the cost of one apple. This 
fact has been stored in our brain by study. We have also 
learned that ten is ten times one. By combining these two 
impressions, we find the cost of one apple by division, and 
then multiply the result by ten. 

Judgment 

Judgment is an act of the brain whereby we are able to 
determine the relation between the impressions that have 
been stored up in the brain as the result of either experience, 
of study or of impressions stored up, or occurring in the brain 
through our senses. For example — we have learned by 
experience, by our sensations, by study, or by all three, that 
certain acts are right and others wrong. 

The foregoing mental activities of the brain are often 
called the higher functions of the brain, because they are 
usually an indication of the degree of intelligence of an in- 
dividual. 

Emotion 

Emotion is an act, whereby the brain modifies the action 
of the body, the consciousness and the motor impulses sent 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 221 

out from the brain. This results because of the expecta- 
tion, knowledge and impressions previously received by the 
brain. For example — in watching an athletic contest, when 
our favorite team is successful, we shout, we laugh, we 
jump, we wave flags; in short, we are more active and more 
conscious. This is the result of the expectation under tension, 
of either the victory or defeat, and the effects of these, as 
learned by our previous experience. 

The grief at the death of a friend or a relative, makes us 
less active, less conscious, less interested in objects about us, 
because of the impressions stored up in the brain as a result 
of the companionship of the deceased, and the contempla- 
tion of conditions due to his absence. . 

Emotions are of three kinds: 

1. Those causing pleasant sensations. These emotions make 
the individual more satisfied; he is more active, more talk- 
ative, his spirits are brightened, he is gay, jolly and laughs 
easily. 

The first example of the successful victory given above, 
is such an emotion. The most important pleasant emotions 
are joy and satisfaction. 

2. Those causing unpleasant sensations. These emotions 
make the body less active. They often cause tremors of the 
muscles, crying, violent movements of the muscles or ex- 
tremities the patient moving constantly about, loss of ap- 
petite, etc. The second example of the grief at the death of 
a friend is such an emotion. 

The most common emotions of this kind, are grief, anger, 
fear, remorse. 

3. Complex emotions. These consist of a mixture of the 
first and second groups of symptoms. These are often called 
the tender emotions. The most common ones are sorrow, 
pity, gratitude, reverence, benevolence, love, sympathy. 

Imagination 

Imagination is an act whereby the brain is conscious of 
objects that cannot be appreciated by the senses. The ob- 
jects we imagine are really new combinations of old impres- 
sions that have been stored up in the brain by the sensa- 



222 MATERIA MEDICA 

tions, such as sight, hearing, touch, etc. ; by study, by read- 
ing or by experience. 

Every new work of the imagination such as a novel, a 
play, an opera, etc., is really a new combination of events, 
impressions, and experiences, encountered by the author 
in his lifetime, or gained by reading or study. There is 
therefore, really "nothing new under the sun." 



Will Power or Inhibition 

Will power or inhibition is an act of the brain whereby all 
its activities, which have just been described, as well as all 
the activities of the spinal cord, are regulated, controlled 
or kept in check. This is one of the highest functions of the 
brain. 

For example: We may have an experience which may 
increase one of our emotions such as grief. Yet we may not 
manifest this grief because our emotion may be controlled 
or inhibited by our will power. 

One of the emotions such as anger, may be stimulated to 
such an extent, as to cause the brain to send out impulses 
to strike the individual who may be the cause of our anger. 
We do not strike him, however, because our emotions are 
kept in check by the inhibitory action of the brain or will 
power. 

All the sensory, motor or mental activities of the brain 
when once performed, leave a record in the brain which may 
be revived at some future time. 



ACTION OF THE CEREBELLUM 

The cerebellum controls our equilibrium, that is, it regu- 
lates our movements in a straight line. It enables us to 
move forward, backwards, from side to side and up and 
down without staggering. 

When the action of the cerebellum is disturbed, the patient 
usually staggers. If one side is affected, the patient usually 
staggers to one side. 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 223 

ACTION OF THE MEDULLA OBLONGATA 

The medulla oblongata joins the brain to the spinal cord. 
It consists of small areas of gray matter within, and white 
matter without. The areas of gray matter are called centers. 
Each center controls a certain action of the body, and con- 
stantly sends out impulses along certain nerves to cause or 
regulate these activities of the body. 

Most of these activities are vital, because without them 
life cannot go on. The most important centers in the medulla 
are: 

1. The respiratory center, which controls breathing. 

2. The cardio-accelerator center, which makes the heart 
beat faster. 

3. The vagus or cardio-inhibitory center, which makes 
the heart beat slower. 

4. The vaso-motor center, which controls the width of 
the blood vessels. 

5. The vomiting center, which sends out impulses to cause 
vomiting. 

ACTION OF THE SPINAL CORD 

The spinal cord is a long cord-like structure situated in 
the spinal canal, running from the skull to the sacrum. It 
has numerous nerves attached to it, which carry impulses 
to and from the cord. 

The spinal cord consists of gray matter within, which 
contains all the cells, and white matter without, consisting 
of the fibers from these cells. 

The function of the spinal cord is to cause an organ of the 
body to act, as a result of an impulse received from that organ, 
or from another part of the body by the spinal cord. Such 
an action, which depends upon an impulse received, is called 
a reflex action. (It is a reflected action, because it reflects 
the impulse received, by another impulse which is sent out.) 

For example: When the bladder is full of urine, an impulse 
is sent from its inner wall to the spinal cord, which at once 
sends back an impulse to contract the muscles in the bladder; 
the urine is therefore expelled and the bladder is emptied. 



224 MATERIA MEDICA 

When a hot object is applied to the skin of the arm, an 
impulse is at once sent to the spinal cord; which imme- 
diately sends out another impulse to make the muscles of 
the arm contract, and the arm is drawn away. 

Reflex actions are controlled by the inhibitory or check- 
ing action of the brain. 

For example: When the bladder is full, it is ordinarily 
prevented from emptying itself for a time. This is due to 
the inhibitory action of the brain which holds the reflex 
action in check. 

THE NERVES 

The nerves are bands of white fibers, which go to, and 
come from the brain and spinal cord. 

The nerves that carry impulses to the brain and spinal 
cord, are called sensory or afferent nerves. 

Those that carry impulses from the brain and spinal cord 
are called efferent nerves. The efferent nerves carry im- 
pulses to make the muscles contract, and to increase the 
secretion of the secretory glands. 

The nerves end in the skin, the muscles, or the various 
organs of the body, by means of small bodies called nerve 
endings. 

CONSCIOUS, SUBCONSCIOUS AND REFLEX ACTION 

The activities of the nervous system are of three kinds. 

1. Conscious 

2. Subconscious 

3. Reflex 

Conscious actions are activities of the brain, of which we 
are aware. These actions occur only in the brain. 

Subconscious actions are activities going on in the brain 
while we are conscious of something else. We usually, how- 
ever, later become conscious of subconscious activities. 

For example: While we are conversing about a certain 
topic, we wish to recall the name of a particular individual. 
We are unable to do so after considerable attempts, and we 
then give up the attempt. Some time later, while we are 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 225 

occupied with another topic, the name suddenly occurs to us, 
and we remember the name we had been trying to find. 

A process has been going on in the brain, without our being 
aware of it, which has brought back the memory of the name. 

Reflex action is an activity which is the result of a stimulus 
received by the sensory nerves from the skin and other parts 
of the body. 

Reflex actions may occur in the brain and spinal cord. 
In the spinal cord all the activities are reflex. 

MODE OF ACTION OF THE NERVOUS SYSTEM 

The action of the nervous system can be easily understood, 
if we compare it to a telephone system. 

A telephone system consists of a central station, which 
receives all the messages from wires leading to, and coming 
from this central station. Messages are sent to the central 
station, by means of the transmitter, and they are received 
through the receiver. 

The central station keeps all the subscribers in touch with 
one another. Some subscribers do not communicate di- 
rectly with the central station, but by means of a sub- 
station, or a private switchboard. This sub-station must 
first be communicated with before reaching the central 
station or any of the subscribers connected to it. 

The nervous system acts in a similar manner (see diagram). 

The brain is the central station, which keeps the various 
organs of the body in communication with one another. 

Some organs such as the eye, the ear and the nose, com- 
municate directly with the brain, through the nerves which 
correspond to the wires of the telephone system. All the 
cranial nerves communicate directly with the brain through 
the nerves which correspond to the wires going directly to 
the central station. 

The sensory nerve endings are the transmitters which 
send impulses along the sensory nerves to the central 
station, the brain. 

The motor or secretory nerve endings are the receivers 
which receive impulses from the brain, the central station. 

The spinal cord is the sub-station or switchboard. 



226 MATERIA MEDICA 

Some parts of the body do not communicate directly with 
the brain, the central station, but through the spinal cord, 
which is the sub-station or switchboard. All the impulses 
from the skin of the trunk and extremities reach the brain 
in this way. All the impulses for motion reach the muscles 
of the extremities and trunk indirectly, through the spinal 
cord. 

Just as an institution, having a private switchboard, can 

Cranial Sensory Nerve"- Sensory Nerve 

•< ■ Ending, 

y Motor or Secretory 




Sensory Nerve m' Spina 1 Sensory Nerve 



w 



Cranial Motor Nerve > r _ Nerve Ending, 



Nerve Fibers 
Connecting the Brain, 
and Spina/ Com/, s 



Ending. 



Motor or Secretory a 

Mfirvt* FnrJinnt. " 




Nerve End incf. ^ Spinal Mqtorjierve 

Diagram illustrating the action of the nervous system. The arrows 
indicate the direction in which the impulses travel 

connect any of its individuals in one part of the building 
with other individuals in a different part of the building; so 
an impulse going to the spinal cord, may cause another 
impulse to be sent out from the spinal cord, without such 
an impulse being sent to, or coming from the brain. Such 
an action is a reflex action. 

Mode of Action 

For example: When an automobile is seen coming along 
the street at great speed, we at once get out of its way. The 
impulse received by the eye when the automobile is seen, is 
sent to the brain. 

The brain then sends out impulses to the spinal cord, 
which in turn sends impulses to the muscles of the lower 
extremities causing them to contract. The legs are then 
moved and we get out of the way of the automobile. 

The eyes are thus kept in communication with the muscles 
of the lower extremities. 

Considering the nervous system as a telephone system, 
the message (the sight of the automobile) is sent to the 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 227 

central station, the brain. This at once sends a message to 
the sub-station, the spinal cord, which in turn sends a mes- 
sage to the lower limbs, causing them to move. 

EFFECTS OF DRUGS ON THE NERVOUS SYSTEM 

Drugs affect the nervous system in two ways. 

1. Increasing its activity, stimulation. 

2. Lessening its activity, depression. 

CEREBRAL STIMULATION 

Drugs may increase the activity of the entire brain, or 
only of certain areas of it. In the latter case, only some of 
the activities of the brain are increased, while others may 
be normal or even diminished. 

Stimulation of the Sensory Activities of the Brain 

When the action of the areas of the brain which receive 
sensory impulses, is increased, the brain receives more 
impulses through the various senses. The patient is there- 
fore brighter, wider awake, and he appreciates his sur- 
roundings better, that is, he is more conscious, because 
consciousness is the result of the sensations received through 
the various senses. 

The patient appreciates all the various sensations better; 
such as the sense of pain, touch, heat, cold, etc. 

Illusions and Hallucinations 

When the various sensory areas of the brain are made 
very active, certain impressions which had been received 
through the various senses and stored up are revived. The pa- 
tient then has sensations which do not exist. For example — 
stimulation of the area for receiving impulses of sight, 
makes the patient see objects that do not exist. Such im- 
pressions are called hallucinations or illusions. In this ex- 
ample they are illusions or hallucinations of sight. 

If the area for the reception of sound is thus overstim- 
ulated, the patient may hear sounds, noises or voices, that 
do not exist. These are called hallucinations of sound. 

If the area for the appreciation of the sense of touch is 



228 MATERIA MEDICA 

over-stimulated, the patient may feel things that do not 
exist, such as objects or animals creeping over the skin. 
This often occurs in alcoholic delirium, or delirium tremens. 
These are called hallucinations of touch. 

If the area of the brain which receives sensations of taste 
or smell is thus affected, the patient may taste or smell 
objects that do not exist. These are called hallucinations or 
illusions of taste or smell. 

Stimulation of the Motor Areas of the Brain 

When the areas of the brain which send out impulses for 
motion, are stimulated, the patient moves about more, and 
is more active, because of the greater number of impulses 
for motion which are sent out from the brain. 

Convulsions 

When the motor areas of the brain are over-stimulated, 
however, the impulses for motion are so strong, and so many, 
that instead of regular coordinated movements of the 
muscles, violent contractions, or convulsions result. 

Convulsions are of two kinds: Clonic and Tonic. 

Clonic convulsions are repeated single contractions of 
the muscles of the body. 

Tonic convulsions are continual contractions of the muscles 
of the body. The muscles are then very stiff and rigid. 

Stimulation of the Speech Center of the Brain 

When the activity of the speech center of the brain is 
increased, the patient becomes more talkative. 

Delirium 

When the activity of the speech center of the brain is 
very greatly increased, for example: by drugs, or by the 
poisons of infectious diseases, all the impressions and mem- 
ories for speech that have been stored up in the brain are 
sent out. 

The patient talks continuously, of numerous objects that 
he has seen in the past, or sees at present. He may speak 
various words of different languages that he has heard at 
some time in his life, etc. This is called delirium. 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 229 

The same causes which increase the activity of the speech 
center, also increase the activity of the motor areas of the 
brain. Delirium is often accompanied then, by excessive 
movements of the muscles and often by convulsions. 

Stimulation of the Mental Functions of the Brain 

Drugs which increase the activity of the brain also in- 
crease the mental activities of the brain. When these 
activities are increased, the patient is able to concentrate 
his mind better and pay closer attention. The reasoning 
and judgment are also increased and the memory is better. 

When the imagination is increased, the patient is better 
able to combine old impressions into new ones. They may 
have visions of various objects, places and people. They 
may imagine new kinds of sounds. 

Often the imagination is increased, while the activity of 
the sensory areas of the brain is lessened. The patient is 
then unconscious (asleep) but the increased activity of the 
imagination results in various dreams. Such effects are 
produced by morphine. 

When the inhibitory action of the brain is increased, the 
patient is able to control the various activities of the brain 
and other organs better. 

STIMULATION OF THE MEDULLA OBLONGATA 

When the activity of the medulla of the brain is increased, 
the various centers which it contains become more active. 
If the respiratory center is stimulated, the breathing is 
deeper and faster. 

If the cardio-accelerator center is made more active, 
the heart beats faster and stronger. 

If the vagus or cardio-inhibitory center is increased in 
activity, the heart beats slower. 

If the vaso-motor center is more active, the blood vessels 
become narrower, and the pulse is tense, and the blood 
pressure is greater. 

If the vomiting center is made more active, the patient 
usually vomits frequently and profusely. 



230 MATERIA MEDICA 

The entire medulla is rarely stimulated. Most drugs 
affect only certain centers in the medulla. 

STIMULATION OF THE SPINAL CORD 

When the spinal cord is made more active the patient is 
able to respond to all stimuli and impressions received by 
the senses, more rapidly and with greater force. 

For example: When the spinal cord is stimulated, the 
application of a hot object to the hand will cause the arm to 
be forcibly drawn away, and may even cause convulsions, if 
the spinal cord is greatly stimulated. 

Drugs which increase the activity of the spinal cord, such 
as strychnine, act as a tonic. This is due to the improvement, 
and greater activity of various organs of the body because 
of the increased reflex action. Such actions as breathing 
and movements of the bowels, which are reflex actions, or 
which are increased by reflex action, are improved. 

STIMULATION OF THE NERVES AND NERVE ENDINGS 

If the sensory nerves or nerve endings are made more 
active, the patient becomes more sensitive to pain, to heat 
and to cold. There may even be tingling in the areas of 
skin affected, a feeling as if there was some object creeping 
on the skin (formication). 

If the efferent or motor nerves are thus affected, the 
patient may have twitchings of the muscles, if they are 
motor nerves or nerve endings. If they are secretory nerves 
or nerve endings, the glands supplied by these nerves secrete 
more profusely. 

EFFECTS OF EXCESSIVE STIMULATION 

When drugs increase the activity of the brain too much 
(over-stimulation), which often results from excessive doses 
of cerebral stimulants, the effects are those of lessened ac- 
tivity or depression. 

The patient becomes less conscious, falls asleep, or becomes 
still more unconscious, and finally goes into a stupor (a deep 
sleep from which he can be awakened with difficulty). 
Later, coma develops (a deep sleep from which the patient 
cannot be aroused at all). 



CEREBRAL DEPRESSION 

Drugs may lessen the activity of the entire brain or only 
of certain areas of it. In the latter case, only some of the 
activities of the brain are lessened, while others may be 
normal or even increased. 

Depression of Sensation 

When the activity of the sensory areas of the brain are 
lessened, fewer sensory impulses reach the brain. 

The sense of pain, touch, heat, cold, sight and hearing and 
all other sensations are lessened. Many drugs such as 
morphine, relieve pain in this way. 

Since consciousness depends upon the sensory impulses 
received by the brain, when the reception of these impulses 
is lessened, the patient is less conscious, or may even be 
unconscious or asleep. 

In overactivity of a cerebral depressant, stupor and coma 
result. 

Motor Depression 

When the action of the motor areas of the brain is lessened, 
fewer impulses for motion are sent out from the brain. The 
patient is then less active, he usually remains in one place 
without any desire to change his position. 

Depression of the Speech Center 

When the activity of the speech center is lessened, the 
patient is less talkative; and when he does speak, he is apt to 
speak slowly and in a low voice. 

Depression of the Mental Functions of the Brain 

Drugs which lessen the mental activities of the brain make 
the patient dull and stupid. He is unable to fix his atten- 
tion or concentrate his mind on any subject, for any length 
of time. The reasoning is very slow and poor, the memory 

231 



232 MATERIA MEDICA 

is very poor and the patient is very forgetful. He is usually 
cold and unemotional. 

When the inhibitory action or will power is lessened, 
the patient is unable to control the various activities of his 
brain and other parts of the body. 

For example: Alcohol stimulates the speech center, but 
lessens the will power. It makes the patient talkative, but 
he often says things however, that may be foolish or im- 
proper. 

DEPRESSION OF THE MEDULLA 

Drugs which lessen the activity of the medulla usually 
lessen the action of its various centers. 

When the action of the respiratory center is lessened, 
the breathing is slower and shallower. 

Lessening the activity of the cardio-accelerator center 
lessens the impulses which make the heart beat faster, so 
that the heart then beats slower and weaker. 

When the action of the vagus or cardio-inhibitory center 
is lessened, fewer impulses for slowing the heart reach it. 
The heart therefore beats faster. 

When the activity of the vasomotor center is lessened, 
the blood vessels become widened and the skin becomes 
flushed. The pulse is therefore softer and more bounding in 
quality. 

DEPRESSION OF THE SPINAL CORD 

When the activity of the spinal cord is lessened, the patient 
usually responds to stimuli less readily. In other words, 
the reflex action is lessened. It therefore lessens the activity 
of various organs of the body such as the movements of the 
bowels, breathing, etc., which are helped by reflex action or 
which act in a reflex manner. 



DEPRESSION OF THE NERVES AND NERVE ENDINGS 

When the activity of the sensory nerves or their nerve 
endings is lessened, the patient does not appreciate sensations 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 233 

such as touch, temperature, pain, etc. It often produces 
numbness in the areas supplied by these nerves. 

When the activity of the efferent nerves is lessened the 
results are: 

Lessened contractions of the muscles if they are motor 
nerves. If the depression is very great, as in over activity 
of the drug, paralysis results. 

Lessening the activity of the secretory nerves or their 
nerve endings, results in diminished secretion of these glands. 

CEREBRAL STIMULANTS 
ALCOHOL (ALCOHOL ETHYLICUM) 

Alcohol is a colorless fluid which evaporates very quickly. 
It has a pungent odor, and a burning taste. It burns very 
easily with a blue flame, and it is often used for heating 
purposes. 

Alcohol is obtained by the growth of the yeast plant, 
(a vegetable organism) in a solution of fruits or vegetables 
containing sugar. This process is called fermentation. 
Starchy fruits or vegetables also produce alcohol on fermen- 
tation, because the starch is changed to grape sugar, which 
is then fermented by the yeast. 

The growth of the yeast plant changes the sugar to alcohol 
and carbon dioxide. 

The fermented fluid is then heated in a large vat. Since 
the alcohol evaporates very easily, it turns to vapor when it 
is heated. The vapor then passes along a series of tubes 
into a cool receptacle, where the vaporized alcohol again 
becomes fluid. This process is called distillation. 

Appearance of the Patient 

After an ordinary dose of any alcoholic liquor, such as 
whiskey or wine, the patient usually becomes cheerful, is 
satisfied with himself, his surroundings, and those about 
him. He is perhaps more active and more talkative. The 
face is flushed, his eyes are bright. The pulse is rapid and 
bounding and the breathing is deeper. 



234 MATERIA MEDICA 

ACTION 

Local action: Applied to the skin, alcohol causes redness 
and itching. It hardens the skin, checks the sweat and acts 
as an antiseptic. Because it evaporates quickly, it makes the 
skin feel cold. If its evaporation is prevented, however, or 
if the skin surface is injured, it becomes red, painful and 
swollen (irritating). 

On mucous membranes : It causes redness, swelling, a burn- 
ing sensation and profuse secretion of mucus. It also hardens 
the cells of the mucous membrane. 

Internal Action 

In the mouth : It has a burning taste, it increases the flow 
of saliva, reddens and contracts the lining membrane of the 
mouth. Strong preparations, such as whiskey, often cause a 
burning sensation of the throat, and, on account of the fumes 
which it produces, it causes a fit of coughing, and a flow of 
tears from the eyes and nose. 

In the stomach: Small quantities of alcoholic liquors aid 
the appetite, increase secretion of gastric juice, and also 
increase the peristaltic contractions of the stomach. The 
food is therefore digested better, and is passed into the in- 
testines more rapidly for further digestion. 

In the intestines: Alcoholic liquors increase the secretion 
of the mucous membrane and also increase the peristaltic 
contractions, thereby acting slightly as a laxative. 

Action after Absorption 

Alcohol is very rapidly absorbed, usually in about fifteen 
minutes. Most of it enters the blood through the lining 
membrane of the stomach, but a small part passes through 
the mucous membrane of the intestines. 

After entering the blood, alcohol affects principally the 
circulation, the respiration, and the brain. 

Action on the Circulation 
On the heart: Alcohol makes the heart beat stronger and 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 235 

faster. On the blood vessels : The blood vessels, particularly 
of the skin, are all widened by alcohol. As a result of this 
action the skin is flushed and the patient feels warm after 
taking alcoholic liquor. 

The total effect of alcohol on the circulation, is to make the 
heart beat stronger and faster and to widen (dilate) the blood 
vessels. 

The pulse is therefore strong, fast and bounding. The 
bounding quality is due to the dilated blood vessels, which 
allow the contractions and dilatations of the heart to be 
more easily transmitted to the blood vessels. 

The effect of alcohol on the circulation lasts only for a 
short time; about an hour or two. 

Action on the respiration: Alcohol makes the breathing 
deeper and faster. 

Action on the brain: Alcohol increases some of the ac- 
tivities of the brain, but lessens other activities, such as the 
will power or inhibitory power, and judgment. It also slightly 
lessens the sense of pain. 

The patient becomes self-confident in his own powers, 
often over confident. He thinks more quickly, is more 
active, he moves about more energetically. He is more 
talkative, but is not as careful as usual of his speech. He 
feels happier, jollier, and somewhat more emotional. 

This increased activity is due to a greater number of 
impulses for motion sent out from the brain. The talkative- 
ness, to increased impulses sent from the speech center in 
the brain. The emotions are made more active, as a result 
of which the patient is happy and jolly. 

The will power and judgment, however, are lessened; so 
that the activity of the brain, while it is greater, is not con- 
trolled. While the patient is more talkative, he is not as 
careful of his speech. The jollity and laughter may be more 
boisterous than usual. The patient may be more emotional; 
but his emotions are not of the higher, more refined type of 
emotion, that result from control; but are rather crude and 
coarse. 

Since the control of the will power over the activity of the 
brain is lessened, the stimulation of the other centers of the 



236 MATERIA MEDICA 

brain is even greater; because their action is not controlled 
by the checking or inhibitory influences of the will power. 

Effect on temperature: Alcohol lowers the temperature 
because the widening of the vessels of the skin makes the 
body lose heat. 

Effect of nutrition: Alcohol has a distinct food value. 
About 90% of the alcohol taken is used up in the body. 
It combines with oxygen and is changed to carbon dioxide 
and water. In this way it gives up a great deal of energy 
for the activity of the cells of the body. It is able, therefore, 
to take the place of such foods as carbohydrates (starches, 
sugars) and fats. 

It is only suitable for temporary use, however, as in fevers, 
because if given for a long time, alcohol injures the various 
organs and tissues of the body. This may neutralize any 
effect it may have as a food. 

Action on the kidneys : Alcohol slightly increases the flow 
of urine. 

Excretion 

About 90% of the alcohol taken is used up in the body. 
The rest is rapidly eliminated by the kidneys, the lungs, and 
the skin, in the urine, the expired air, and the sweat. 

Poisonous Effects 

Acute alcoholic poisoning results from drinking alcoholic 
liquors to excess; and produces the familiar and far too 
common picture of drunkenness. 

Symptoms 

Large quantities of alcoholic liquors usually cause marked 
excitement. The individual is quite talkative, active and 
moves about. He is usually jolly, boisterous, and often 
quarrelsome. The face is flushed, the pulse is strong, rapid, 
and bounding, the breathing is somewhat faster and the eyes 
are bright. The excitement is often increased by the brilliant 
surroundings in which alcoholic liquors are usually indulged. 
The thoughts flow freely, perhaps too freely. The speech 
may be brilliant, but is loud, and the individual is not at all 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 237 

careful of what he says. Even the words may not be spoken 
distinctly. This is due to the lack of controlling influences 
over the speech center, and its increased activity as a result 
of the alcohol. 

The patient moves about, but his movements are undigni- 
fied and he may even be unsteady in his gait and stagger, 
because the movements are not controlled by the will power. 

The emotions too, are increased. There may be sudden 
outbursts of anger, he may become quite sentimental and 
sensual. This is due to the lack of control by the inhibitory 
or checking influence of the will power. The emotions, 
therefore, lack their finer restraining qualities. 

The anger may be unreasonable and the sentiments are 
coarse, and there may be base sensual ideas. 

The lessening of the will power and judgment is marked, 
too, in the disregard for conventionalities and for the feelings 
of others that drunken individuals usually have. 

All these effects are due not alone to the increased activities 
of the various centers of the brain, but to lessening the 
activity of the will power, which is unable to check or regu- 
late the activity of the brain. 

When still larger quantities of alcoholic liquors are taken, 
there is marked nausea and vomiting, the staggering gait is 
very marked. The over activity of the brain finally ex- 
hausts it, and the individual then has symptoms of lessened 
activity or depression. He falls into a deep sleep (stupor), 
and becomes unconscious. All his sensations are diminished, 
and the reflex action is lessened. The face looks pale and is 
often blue or cyanosed, the breathing becomes slow and 
snoring in character (stertorous). The pulse is usually 
strong and bounding. In this stage the patient may lose 
control of his bladder or rectum. 

With larger doses of alcoholic liquors, this condition may 
gradually grow worse, the patient goes into coma, the breath- 
ing is very slow and shallow, the pulse becomes rapid and 
weak and death may result from failure of the respiration. 

Usually, however, the effects wear off in a few hours, the 
stupor gradually wears off and the patient gradually be- 
comes conscious. 



238 MATERIA MEDICA 

The effects of overdoses of alcohol vary with different 
individuals. Some become sentimental, others quarrelsome, 
and still others fall asleep and have no excitement stage at 
all. 

When alcoholic liquors are taken in company, amidst 
brilliant surroundings, it is more apt to cause excitement. 

Fatal results have occurred from a dose of 200 c.c. (1 pint) 
of whiskey. 

Treatment 

1. Wash out the stomach. 

2. Give artificial respiration if the breathing is slow 
and shallow. 

3. Apply cold applications to the head. 

4. Keep the patient warm. 

5. Give stimulants; such as ammonia, strychnine, etc. 



CHRONIC ALCOHOL POISONING, OR " ALCOHOLISM " 

Chronic alcohol poisoning results from habitually taking 
alcoholic liquors, especially distilled liquors, such as whiskey, 
gin, etc., because these contain large quantities of alcohol. 
Rarely, these symptoms result from habitually drinking 
beers or wines. 

The injurious effect of alcohol is due to the fact that, if it is 
taken habitually, it dissolves some of the substances in the 
functionating cells of the various organs of the body. As a 
result of this, many of these cells are destroyed, and their 
place is taken by connective tissue; which is not an active 
part of an organ. The organ thus affected is then not able 
to perform its work as well as before, and the patient suffers 
from various symptoms as a result of it. 

The organs usually affected are the stomach, the liver, 
the blood vessels, the nervous system, and the kidneys. 

The stomach is affected by habitual alcoholism, so that 
many of the cells of its lining membrane are destroyed, 
their place being taken by connective tissue, and chronic 
gastritis results. The result of this is that the stomach 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 239 

secretes less gastric juice, and the patient suffers from various 
digestive disturbances. 

The secretion of mucus from the stomach is increased, 
the patient's tongue is dry and brown, the lips are red, and 
he usually complains of pain in the region of the stomach. 
Often he has nausea and vomiting in the morning. 

The liver is often similarly affected. Some of its cells 
being destroyed, and replaced by connective tissue, a con- 
dition known as cirrhosis of the liver results. This makes 
the liver very hard and interferes with its circulation. The 
patient then often develops fluid in the abdomen from 
accumulation of the blood in the abdominal vessels. Digest^ 
ive disturbances also result from this condition. 

The blood vessels become thickened by habitual alcohol- 
ism, because there is more connective tissue formed in their 
walls. This condition is known as arteriosclerosis. The 
patient then suffers from various symptoms as a result of 
the disturbed circulation in various organs. The blood 
pressure is very high, the patients have headaches, and 
numerous other symptoms. 

The heart may also be affected by alcohol, so that numer- 
ous areas of connective tissue may be formed in it. Disturbed 
heart action, often weakened heart action (myocardial 
insufficiency) may result. 

The kidneys, too, are very frequently affected by habitual 
alcoholism, connective tissue replacing the cells which have 
been destroyed. The patient then suffers from chronic 
nephritis (Bright's disease). Small quantities of urine are 
passed. There may be oedema of the extremities, fluid in 
the tissues, etc. 

Alcohol is particularly injurious to the nervous system. 
It destroys many of the cells of the gray matter of the 
brain. It is an important predisposing factor, often the 
cause, of various forms of insanity, of paralyses, etc. 

The nerves are also affected by alcohol. Paralysis of the 
muscles of the arms and legs often results from the effects 
of habitual alcoholism (alcoholic multiple neuritis). 

Other evidences of chronic alcoholism are a red nodular 
nose, dilated blood vessels of the skin, especially on the face, 



240 MATERIA MEDICA 

and waxy, dry, soft skin. The mind is often sluggish and 
weak. 



DELIRIUM TREMENS 

This is a special kind of temporary alcoholic insanity, 
which occurs in habitual drinkers, when they receive any 
shock, such as from an injury, or haemorrhage, when they 
suffer from an infectious disease, or when they have under- 
gone a surgical operation. 

The symptoms are due to the patient being deprived of 
his usual amount of alcohol. 

The symptoms are: hallucinations of the various senses, 
abnormal fear, tremors of the muscles and excitement. 

The patient often sees various animals such as snakes, 
rats, dogs, etc., before him (hallucinations of sight) or he feels 
them creeping upon him (hallucinations of touch). Often 
he hears voices and is constantly talking to those who seem 
to be speaking to him. The patient usually has trembling 
of the muscles of the extremities and is afraid of everybody 
about him. 

This condition usually disappears, if alcoholic liquors 
are given. It can be avoided if alcohol is given regularly to 
those patients who take it habitually, whenever they are 
subject to any shock, or when they have undergone a surgical 
operation. 

Uses 

Locally, alcohol is used: 

1. To harden the skin and prevent bed sores. 

2. As an antiseptic; 50% alcohol is the best preparation 
for antiseptic use. 

Internally, alcohol is used: 

1. As a cardiac and respiratory stimulant in cases of 
shock and collapse. Whiskey and brandy are usually used 
for this purpose. 

2. In cases of sudden chill, whiskey or brandy in hot 
water, relieves the congestion of the internal organs, by 
widening the vessels of the skin. 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 241 

3. In acute infectious diseases, such as typhoid, septicae- 
mia, pyaemia, etc. 

In these cases it not only acts as a food, but it helps to 
increase the resistance of the body against the infectious 
agent, so that the body is better able to overcome the infection. 
In such cases, the pulse will become slower, the temperature 
is lowered, the breathing becomes slower and deeper. The 
delirium and other nervous symptoms are lessened, and sleep 
is induced. The tongue becomes moist and the skin per- 
spires more profusely. 

When these effects are produced, alcohol is acting favor- 
ably. 

WTien, however, alcohol causes a full, rapid, strong, 
bounding pulse; the delirium, restlessness, uneasiness, and 
other nervous symptoms, are increased; the sleeplessness 
increases and the tongue and the skin remain dry, the alcohol 
is acting unfavorably, and it should be stopped. 

4. In poisonous snake bite, alcohol, in the form of whiskey 
or brandy, should be given in very large doses. 

5. In some individuals, alcohol may be used as a hypnotic. 
Beer, brandy, or whiskey and water, may be used for this 
purpose. 

6. Brandy occasionally checks diarrhoea. 

7. Dilute alcohol is a very valuable antidote in carbolic 
acid poisoning. 

Tolerance 

Individuals who take alcoholic beverages habitually, 
can take large quantities of alcohol without any of the usual 
symptoms being produced. This condition is known as 
tolerance for alcohol. To obtain effects in such individuals, 
much larger doses than usual must be given, often even 
more than twice the usual dose. 

Administration 

For local use the preparations of alcohol are used. 
For internal use alcoholic liquors are principally used. 
For temporary use and for immediate effects the distilled 
liquors, such as whiskey or brandy, are the best. 



242 MATERIA MEDICA 

For immediate effect they are best given hot, and not 
diluted very much. Ordinarily, brandy or whiskey are best 
given diluted in a small glass, full of cracked ice, very often 
in vichy or seltzer, or with milk and egg in the form of a 
milk punch or egg nogg. 

In collapse brandy and whiskey are frequently given hypo- 
dermically. 

For continued use the fermented liquors such as wine or 
beer are used. 

Preparations 

For local use 
Alcohol 
(Alcohol) 

This contains 95% of ethyl alcohol by volume, and 92% 
by weight. It is used for rubbing the skin, to prevent bed 
sores, and for burning. 

Absolute alcohol 
(Alcohol absolutum) 

This contains 99% of ethyl alcohol. It is not ordinarily 
used, except by pharmacists and in laboratories. 

Dilute alcohol 
(Alcohol dilutum) 

This contains about 50% of ethyl alcohol by volume and 
about 41% by weight. This is the best preparation to use 
for antiseptic use. 

For internal use 

Alcoholic Beverages 

Distilled liquors 

Whiskey 15.0 c.c. %\ 

(Spiritus Frumenti) 

This contains about 44 to 50% of ethyl alcohol by weight, 
and about 50 to 56% by volume. Whiskey is made by dis- 
tilling fermented grain or other starchy plants. It should 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 243 

be at least four years old, because the fresh preparations are 
too injurious to the tissues. 

There are several kinds of whiskey. 

American whiskey, made by distilling fermented rye and 
corn. 

Scotch whiskey, made by distilling fermented barley. 

Irish whiskey, made by distilling fermented potatoes. 

Brandy or Cognac 15.0 c.c. 5i 

(Spiritus Vini Gallici) 

This contains about the same percentage of alcohol as 
in whiskey. Brandy is made by distilling fermented un- 
changed juice of fresh grapes. It should be at least four years 
old, because the fresh preparations are injurious to the tis- 
sues. There are two kinds of brandy, pale and dark. The 
dark brandy contains caramel. 

Brandy or cognac contains small quantities of tannin. 
As a result of this, it has a tendency to contract mucous mem- 
branes. It is therefore more soothing to the stomach and 
intestines, and has a tendency to constipate and check diar- 
rhoea. 

Rum (not official) 15.0 c.c. 5i 

Rum contains the same percentage of alcohol as whiskey. 
It is made by distilling fermented molasses. 

Gin (not official) 15.0 c.c. 5| 

Gin contains about the same percentage of alcohol as 
whiskey. It is made by distilling fermented rye, or barley, 
and flavored with juniper berries. Because of the juniper 
which it contains, gin increases the flow of urine (diuretic). 

Fermented Liquors 
Wines 

Wines are fermented liquors, made from grapes. Besides 
the alcohol, wines contain various acids such as tartaric 
and tannic acids, and some volatile oils. 

There are several kinds of wines: 



244 MATERIA MEDICA 

White wines. 
Red wines. 
Of these, there are several kinds: 
Dry wines. 
Sweet wines. 
Sparkling wines. 

White Wines (Vinum Album) 

White wines are made by fermenting grapes without the 
skins, stems or seeds. They contain 7 to 12% of alcohol. 

Dry wines are those which contain no added sugar. 

Sweet wines are those which contain sugar which has been 
added. 

Sparkling wines are those which are bottled before fermen- 
tation is complete. They contain carbon dioxide gas, and 
effervesce. 

The most important white wines are: 

Dry white wines, such as rhine wines. They contain about 
10% of alcohol. 

Sweet white wines, such as tokay wines. These contain 
about 14% of alcohol. 

Sparkling white wines, the most commonly used spar- 
kling white wine is champagne, which is a French white wine. 
It contains about 10% of alcohol. 

Champagne should be given ice cold, in teaspoonful 
doses. It is particularly valuable in cases of nausea and 
vomiting, for example, after an operation. 

Champagne is not so effective when the gas escapes. To 
avoid this, a special tap is inserted in the cork, and the 
bottle should be kept on ice, upside down. 

Red Wines (Vinum Rubrum) 

Red wines are made by fermenting colored grapes with 
the skins. They contain larger amounts of alcohol than 
the white wines. 
Dry Red Wines : 
Claret 

This contains about 8-10% of alcohol. 
Sherry (Vinum Xericum) 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 245 

Sherry contains about 15-20% of alcohol and is often 
made artificially. 

Port Wine (Vinum Portense) 

This is the strongest red wine, and contains about 20-40% 
of alcohol. 

Sweet Red Wines : The most common sweet red wines used 
are burgundy and madeira. They contain from 6-20% of 
alcohol. 

Sparkling Red Wines: The most common sparkling red 
wine is sparkling burgundy, which contains about 10% of 
alcohol. 

Uses of Wines 

The wines are not as stimulating as the distilled liquors, 
such as whiskey or brandy. They are, however, better suited 
for continued use. They aid digestion when taken during 
meals. Sweet wines, however are apt to disturb digestion. 

The wines contain tannic acid and contract mucous mem- 
branes (astringent action). They are therefore more con- 
stipating than the distilled liquors. 

Sparkling wines, such as champagne, are soothing to the 
stomach when given in small doses. They are not as stimu- 
lating to the heart. Champagne causes intoxication easily, 
in spite of the small quantities of alcohol which it contains. 
When taken in larger quantities it is apt to cause headache, 
pains in the stomach, nausea, hiccough, etc. 

Beers 

Beers are made by fermenting starchy grains. They are 
usually made by fermenting brewed barley malt (barley 
which has begun to grow and the growth stopped), with 
hops. 

Ale, porter and stout, are the various kinds of beers that 
are used. They contain about 3-10% of alcohol with a 
large amount of solids, mainly sugar and starches. Because 
of the starches and sugar which they contain, beers are very 
nutritious. They occasionally disturb digestion however. 



246 MATERIA MEDICA 

Liqueurs are preparations of volatile oils containing al- 
cohol. Many of them contain sugars. One of them (kirch- 
wasser) contains very small quantities of hydrocyanic acid. 

Various essences of flowers, such as eau de cologne, contain 
large amounts of alcohol. Cases of alcoholism occasionally 
occur in women from drinking eau de cologne. 

WOOD ALCOHOL (METHYL ALCOHOL) 

Wood alcohol is made by the destructive distillation of 
wood. It is very inflammable, and because of its cheapness 
it is used to dissolve various substances. 

Wood Alcohol is a Distinct Poison 

A single overdose causes the following symptoms: 

1. Nausea. 

2. Vomiting. 

3. Great muscular weakness. 

4. Weak pulse. 

5. Violent delirium. 

6. Goma. 

A number of cases of death have occurred from a single 
overdose of wood alcohol. 

Chronic Wood Alcohol Poisoning 

If wood alcohol is taken either internally, or applied 
externally for a long time, blindness may result from de- 
struction of the optic nerve (optic nerve atrophy). 

Unfortunately, wood alcohol is too commonly used by 
unscrupulous manufacturers, in the manufacture of various 
essences such as soda water flavors, Jamaica ginger, witch 
hazel, bay rum, cologne, etc. Many patent medicines, such 
as peruna and others, contain wood alcohol. 

The use of all preparations of wood alcohol should be 
avoided ; both for internal and external use. They are very 
apt to result in blindness or other dangerous symptoms. 

There are numerous other alcohols such as propyl alcohol, 
butyl alcohol, amyl alcohol, etc., which result in the distilla- 
tion of ordinary wood alcohol. 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 247 

Amyl alcohol, or fusel oil, is very injurious when applied 
locally. It is often present in freshly distilled preparations 
of whiskey. 

ATROPINE GROUP OF DRUGS 

The following group of drugs produce similar effects 
because they contain the same active principles. 

The active principles occurring in these plants are the 
alkaloids: 

Atropine 

Hyoscyamine 

Hyoscine 

and sometimes atropamine and belladonine. 

All these alkaloids are closely related to one another, 
and some of them are compounds of still simpler alkaloids. 

Atropine is really a strong compound of a still simpler 
alkaloid, tropine, with tropic acid. 

By decomposing atropine and combining another acid 
with the tropine, artificial alkaloids are formed. Homat- 
ropine, for example, is a compound of tropine with another 
acid (oxytoluic acid). 

Hyoscyamine has the same chemical composition as atro- 
pine. There is very little difference between them. 

Hyoscine or scopolamine is closely related to atropine. 
It consists of scopoline or oscine, an alkaloid combined with 
tropic acid. 

The drugs which contain these alkaloids all belong to the 
group of plants known as the Solanaceae. (The potato and 
egg plants also belong to the same group.) 

The most important plants of this group are : 

Atropa Belladonna (Deadly Nightshade) 

This contains atropine, hyoscyamine, and hyoscine and small 
quantities of atropamine and belladonine. 

Hyoscyamus Niger (Henbane) 

This contains hyoscyamine, hyoscine, and small quantities 
of atropine. 



248 MATERIA MEDICA 

Datura Stramonium (Thornapple) 

This contains atropine, hyoscyamine and some hyoscine. 
Other less important plants of this group are : 

Duboisa Myoporoides 

This contains hyoscine and hyoscyamine and several 
other alkaloids. 

Another species of this plant contains an alkaloid piturine, 
which is closely allied to nicotine. 

Scopola Atropoides 

This contains hyoscyamine and hyoscine, with small 
quantities of atropine. 

Mandragora Autumnalis or Atropa Mandragora (Mandrake) 

This contains hyoscyamine, with traces of other alkaloids. 

Potato leaves and tobacco leaves, which belong to the 
same group of plants, also contain very small quantities of 
one or a number of these alkaloids. 

BELLADONNA AND ATROPINE 

Belladonna is a drug obtained from the leaves and roots 
of the Atropa belladonna or deadly nightshade. It is a peren- 
nial plant, about three feet high, which ordinarily grows in 
England and other parts of Europe, but it has also been 
cultivated in this country. 

The active principles of belladonna are the alkaloids: 

Atropine 

Hyoscyamine 

Hyoscine 

Sometimes atropamine and belladonnine also occur. 
The effects of belladonna are due to the atropine which 
it contains. This is preferred for internal use. 

Appearance of the Patient 
After administration of atropine, or one of the atropine 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 249 

containing drugs, such as belladonna or hyoscyamus, the 
following effects are produced within ten minutes to a half 
hour. 

The patient looks brighter, the face and neck are some- 
what flushed, and the pupils are dilated. He is more wakeful, 
restless, more active and talkative. 

The pulse is rapid and strong and the breathing is deeper 
and faster. Various cramp-like pains, such as pains in the 
stomach, intestines, or bladder, from which the patient may 
be suffering, are relieved. 

The patient complains of dryness of the mouth and throat 
and because of this he complains of thirst. The skin usually 
feels dry, and may be quite red. 

If the patient has an attack of shortness of breath, it is 
usually relieved by atropine. 

ACTION 

Local action: On the skin, atropine relieves pain, and 
checks the secretion of sweat. This effect is produced by 
paralyzing the sensory nerve endings in the skin. It is 
often used for this purpose in the form of a belladonna 
plaster. Atropine or belladonna is readily absorbed from 
the skin if applied in a solution of alcohol, glycerine, or 
camphor, or in the form of a plaster. It often causes general 
effects or even poisonous symptoms from such applications. 
On mucous membranes : Atropine checks the secretion. 

Internal Action 

In the mouth: Atropine has a bitter burning taste, and 
checks the secretion of saliva and mucous. It makes the 
mouth and throat feel dry. 

In the stomach: The secretion of gastric juice is lessened, 
and the digestion of food is therefore retarded. The peristal- 
sis of the stomach is also greatly lessened by atropine. 

In the intestines : Atropine checks the secretion of the mu- 
cous membrane of the intestines and lessens the peristaltic 
contractions of its muscle wall. It is often used for this pur- 
pose to check the griping pains of cathartics. 



250 MATERIA MEDICA 

Action after Absorption 

Atropine enters the blood through the mucous membrane 
of the stomach. It is rapidly absorbed, usually within a half 
to one hour. After absorption, it is carried by the circulation 
of the blood to various organs of the body; but it affects 
principally the heart, the respiration, the brain, all the 
secretory glands, the involuntary muscles and the pupil. 

Action on the heart: Atropine makes the heart beat faster 
and stronger. The systoles, or periods of contraction of the 
heart are increased, while the diastoles or periods of relaxa- 
tion are lessened. The heart then expels more blood and 
with greater force. 

This effect is produced by atropine paralyzing the nerve 
endings in the heart, of the Vagus or inhibitory nerves. 
The checking or slowing influence is then taken away from 
the heart, so that no impulses reach the heart, to make it 
beat slower. 

As a result of this effect the accelerator nerves have full 
play, and more impulses reach the heart to make it beat 
stronger and faster. 

Action on the blood vessels: The blood vessels of the 
abdomen are narrowed by the contractions of their muscle 
fibers, as a result of impulses which reach them from the 
vaso constrictor center in the medulla of the brain. The 
blood vessels of the skin, however, are widened. This causes the 
flushing of the face and neck and other parts of the skin, 
often produced by atropine. The blood pressure is increased, 
however. 

The pulse resulting from atropine is therefore rapid, strong, 
and tense. 

(Occasionally atropine may make the pulse slow for a few 
moments.) 

Action on the respiration: Atropine makes the breathing 
faster and deeper. More air, and therefore more oxygen, is 
taken into the lungs. The blood is then able to take up 
more oxygen and to get rid of its waste products more 
rapidly. 

Action on the nervous system: Atropine increases the 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 251 

activity of the brain. This produces wakefulness and rest- 
lessness, because the patient is more conscious. This results 
because the areas of the brain which receive sensations, are 
made more active. More sensations are then received 
through the various senses. 

The patient is more active and more talkative, because 
the motor and speech areas of the brain are more active, 
and these areas send out more impulses. 

In overdoses, atropine causes symptoms of lessened 
activity of the brain (depression), because the brain then 
becomes exhausted from over activity. 

Action on the secretory glands: The secretion of all the 
secretory glands is diminished by atropine. This effect is 
produced by paralyzing the nerve endings in the glands of 
the nerves which cause secretion. 

The secretion of saliva, of the mucous glands of the nose, 
throat, larynx, and bronchi are diminished. 

This causes the dryness of the mouth and throat and the 
resulting excessive thirst. Hoarseness also occasionally 
occurs from checking the secretion of the secretory glands 
in the larynx. 

The secretions of the glands in the mucous membranes 
of the stomach and intestines are checked. The secretion of 
pancreatic juice and of bile is also lessened. 

Atropine also lessens the action of the cells of the liver, 
so that less sugar is formed from the glycogen, or animal 
sugar, which is stored up in the liver. 

Atropine checks especially, the secretion of sweat and 
milk. The secretion of the kidney, however, is not affected 
by atropine. 

Action on the involuntary muscles : Atropine lessens the con- 
tractions of all the involuntary muscles, by paralyzing the 
nerve endings of the nerves which carry impulses to these 
muscles. The contractions of all organs containing in- 
voluntary muscles are therefore lessened. 

Thus, the peristalsis of the stomach and intestines is 
lessened. The contractions of the bladder and uterus are 
soothed by atropine, and the contractions of the bronchial 
muscles are also lessened. 



252 MATERIA MEDICA 

(Atropine, or drugs containing atropine, are often used to 
relieve contractions of these muscles which often produce 
asthmatic attacks.) 

Action on the pupil: Atropine dilates the pupil by paralyz- 
ing the nerve endings of the nerves in the circular muscle 
fibers of the iris, or colored part of the eye. The radial 
muscles then have free play, and their contractions widen 
the pupil. The widening of the pupil may last for days. 

After atropine, patients are unable to see near objects 
clearly. This is due to the paralysis of the nerve endings of 
the ciliary muscle, a muscle which changes the contour of 
the lens for near and distant objects (accommodation). The 
relaxation of this muscle, prevents the lens from changing 
its contour for near objects, which cannot then be seen. 

Effect on the temperature: Atropine often causes a rise 
of temperature. 

Excretion 

Atropine or a drug containing atropine, is excreted mainly 
by the kidneys. It is eliminated in about ten to twenty 
hours after being given. 

Idiosyncrasies 

The following unusual effects occasionally occur: 

1. Ordinary doses of atropine sometimes cause delirium. 

2. When applied to the conjunctiva of the eye, atropine 
often causes inflammation of the eyelids and face. 

3. The rash caused by atropine, may spread all over the 
body, and the skin may peel (desquamate). This rash may 
be mistaken for scarlet fever. 

Poisonous Effects 

Acute atropine poisoning usually results from excessive 
doses of atropine or drugs containing atropine. Dangerous 
symptoms have occurred from gr. 2V - tV and death has oc- 
curred in about six hours after it was taken. 

Since atropine is rapidly excreted, cumulative symptoms, 
or chronic atropine poisoning does not occur. 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 253 

Symptoms 
The earliest and most characteristic symptoms of atropine 
poisoning are : 

1. Dryness of the mouth and throat. 

2. Excessive thirst. 

3. Difficulty in swallowing. 

These symptoms result because the secretions of the 
mouth and throat are checked. In addition to these symp- 
toms there may be: 

4. Hoarseness. 

5. Occasionally nausea and vomiting. 

6. Often headache and dizziness. 

7. Redness and dryness of the skin, especially of the face 
and neck. 

8. The pulse and breathing is very rapid at this time. 

9. The pupils are widely dilated and the sight for near ob- 
jects is indistinct. 

If very large doses of atropine are taken, these symptoms 
are soon followed by: 

1. Intense thirst with inability to swallow. 

2. Great hoarseness with difficult and indistinct speech. 

3. The pulse becomes rapid, 150 to 160, and the breathing 
is very rapid. 

4. The pupils are widely dilated, and the eyes are very 
staring. 

5. There is often restlessness and other symptoms resulting 
from excessive activity of the brain. 

The patient may have a staggering gait and be very active, 
is very talkative, but his ideas are easily confused. He may 
begin a sentence and not finish it. He is very light-headed, 
may burst out into laughter or tears. Occasionally there may 
be various illusions; especially illusions or hallucinations of 
sight. Patients often see various objects about them which 
are not present. 

The patient then becomes delirious. The delirium is 
peculiarly wakeful, active, and talkative. The patient lives 
in a world of his own. He is constantly interested in 
talking to objects and persons which he seems to see about 
him and which occupy his entire attention. He is entirely 



254 MATERIA MEDICA 

unconscious of the real objects present about him. Often 
the patient becomes quarrelsome, even maniacal, and has 
to be restrained. 

Finally, tremors of the muscles develop, the patient may 
have convulsions followed by paralysis. The breathing 
becomes slow and shallow, the face blue, and the patient dies 
from cessation of breathing. 

Usually however, the excessive excitement is followed by a 
deep sleep which gradually becomes still deeper (stupor). The 
patient then goes into coma (a very deep sleep from which he 
cannot be awakened). The breathing becomes slow and 
shallow, the face is blue (because of the insufficient oxygen 
entering the lungs), the pulse becomes slow, irregular and 
weak, the temperature is below normal, the extremities are 
cold and the patient dies from asphyxia. 

All these symptoms are the result of excessive stimula- 
tion of the brain, of the heart and the respiration, as a result 
of atropine. This causes the violent talkative delirium. The 
illusions of sight are produced by the excessive activity of 
the area of the brain where impressions of sight are received 
and stored up. Old impressions that had been received 
and stored up in the brain are thus sent out, and the patient 
seems to see the objects which are not present. 

The very rapid pulse, and respiration too, are evidences 
of over stimulation. When the heart and respiration be- 
come exhausted, however, from this over activity, the pulse 
and respiration both become slow. 

The dryness of the throat and the dilatation of the pupil, 
which are so characteristic of atropine action, are due to 
the excessive effect of atropine on the nerve endings. 

The stupor and coma are the symptoms of exhaustion 
which result from the excessive over activity of the brain. 

Treatment of Atropine Poisoning 

1. Wash out the stomach, or give emetics. 

2. Give cathartics. 

3. Catheterize the patient, to avoid reabsorption of the 
atropine from the urine in the bladder, especially since the 
patient does not pass much urine in atropine poisoning. 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 255 

4. Give tannic acid, as this combines with the atropine 
and neutralizes it. 

5. Keep the body warm, give mustard baths. 

6. Give artificial respiration if the breathing is embar- 
rassed. 

7. Give heart and respiratory stimulants such as whiskey, 
caffeine, strychnine, etc. 

8. Do not give morphine, for, while atropine, is the anti- 
dote for morphine, the dangerous effects of atropine are due 
to the exhaustion of the breathing. If morphine is given in 
such cases, the breathing is only made slower. Morphine, 
therefore is not an antidote for atropine, though atropine is 
an antidote for morphine. 

Uses 

The most important uses of atropine or belladonna are. 

1. In the form of a belladonna plaster or liniment, atro- 
pine or belladonna is used to relieve pain, on the area where 
it is applied. 

2. As a cardiac and respiratory stimulant, especially 
where immediate effects are desired. 

3. As an antidote for morphine poisoning. It is very 
often given together with morphine to avoid poisonous 
effects. 

4. Atropine is often given to check secretions, for ex- 
ample — to check profuse sweating, or to check the secretion 
of milk. 

5. To lessen cramp-like pains produced by contractions 
of involuntary muscles. It is often prescribed together with 
purgatives to lessen their griping. It relieves the colic which is 
produced by the contractions of the involuntary muscles 
of the bile ducts resulting from the passage of a stone along 
these ducts. For the same reason, it relieves the colic of the 
ureters of the kidney (renal colic) resulting from the passage 
of a stone or other substance along the ureter. 

By lessening the contractions of the involuntary muscles 
of the stomach, it often relieves the pains of ulcers of the 
stomach. 

It frequently relieves painful urination which is produced 



256 MATERIA MEDICA 

by the spasmodic contractions of the involuntary muscles 
at the neck of the bladder. 

6. Atropine is very often used to relieve bronchial asthma. 
It is particularly valuable in this condition, because it 
lessens the spasm of the involuntary muscles of the bronchi, 
and at the same time it checks the secretion of its mucous 
membranes. 

7. Atropine is very often used to dilate the pupil, so that 
the retina or background of the eye may be more easily 
examined, and to prevent adhesions between the iris and lens, 
when the iris is inflamed. 

8. It is very often used in diabetes in large doses. It 
lessens the amount of sugar present in the urine. The reason 
for this effect is unknown, but it is probable that it may be 
due to atropine lessening the formation of sugar in the liver 
cells. 

Preparations 
Preparations Made from the Leaves 
For Internal Use 
Extract of Belladonna Leaves 0.005-0.03 gm. gr. T V~ £ 
(Extractum Belladonnae Foliorum) 

Tincture of Belladonna Leaves 0.3 -1.0 c.c. m. v-xv 
(Tinctura Belladonnae Foliorum) 

For Local Use 

Belladonna Ointment 
(Unguentum Belladonnae) 

This contains about 10% of the extract of belladonna. 

Belladonna Plaster 
(Emplastrum Belladonnae) 

This contains 3 parts of the extract of belladonna and 7 
parts of adhesive plaster. 

Preparations Made from Belladonna Root 

For Internal Use 
Fluidextract of Belladonna Root 0.06-0.12 c.c. m. i-ii 
(Fluidextractum Belladonnae Radicis) 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 257 

For Local Use 
Belladonna Liniment 
(Linimentum Belladonnae) 

This consists of the fluid extract to which has been added 
about 5% of camphor. 

Preparations of Atropine 

For Internal Use 

Atropine 0.0004-0.001 gm. gr. T fo - ¥ V 

(Atrophia) 

Atropine Sulphate 0.0004-0.001 gm. gr. rh-ih 

(Atropinae Sulphas) 

For hypodermic use, atropine often comes in tablets, 
each containing the required dose, or in i to 1% solutions. 

For Local Use 
Oleate of Atropine 
(Oleatum Atropinae) 

This contains about 2% of atropine. 

Atropine Ointment 
(Unguentum Atropinae) 
(Not official) 

This contains about 4% of atropine. 

Homatropine 

Homatropine is a compound of tropine, an alkaloid ob- 
tained by decomposing atropine, combined with oxytoluic 
acid. 

Its effects are similar to those of atropine. It dilates the 
pupil more rapidly than atropine, and the effect is not so 
lasting. It is said to slow the pulse, instead of making it 
more rapid. It is not so apt to cause general symptoms as 
easily as atropine from its local use; as in its applications to 
the eye. 

Homatropine is used principally to dilate the pupil. It 
is dropped locally into the conjuctiva. 



258 MATERIA MEDICA 

Preparations 

Homatropine Hydrobromide. 0.0006-0.001 gm. gr. tw~*V 
(Homatropinae Hydrobromidum) 

It is used principally in 1 to 1% solutions for local ap- 
plications in the eye. 

STRAMONIUM (THORN APPLE, JAMESTOWN WEED) 

Stramonium is obtained from the leaves of the Datura 
stramonium, a weed growing in England and the United 
States. It is known by various names, such as Jamestown 
weed, thorn apple, or gypsum. Its active principles are 
the alkaloids, atropine and hyoscyamine, and it also contains 
small quantities of hyoscine. 

Appearance of the Patient 

When a preparation of stramonium is given, or the fumes 
of burnt stramonium leaves inhaled, the patient is relieved 
of the asthmatic attack from which he may be suffering. 
The breathing is easier, the pulse is strong and rapid. The 
patient complains of dryness of the mouth and throat and 
is very thirsty. The pupils are dilated, and the patient is 
somewhat more active and more talkative. 

ACTION 

The effects of stramonium are like those of belladonna; 
and are due principally to the atropine which it contains. 

Local action: Applied to the skin, stramonium relieves 
pain and checks the secretion of sweat. On mucous mem- 
branes: It checks the secretions. 

Internal Action 

In the mouth: Stramonium checks the secretions. 
In the stomach and intestines: The secretions and peristal- 
sis are increased. 

Action after Absorption 

Stramonium is rapidly absorbed through the mucous 
membrane of the stomach. It is usually given by inhalation, 
by burning the stramonium leaves. It is then rapidly 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 259 

absorbed through the mucous membrane of the lungs. 
After absorption, stramonium affects the same organs as 
atropine and it produces the same effects. 

Action on the heart: It makes the heart beat stronger 
and faster and makes the pulse stronger and faster. 

Action on the respiration : Stramonium makes the breathing 
deeper, and faster, but easier. 

Action on the brain: It makes the patient more wakeful, 
more active, and more talkative, because of the increased 
activity of the brain. 

Action on the secretory glands: Stramonium lessens the 
secretion of all the secretory glands. The secretion of saliva^ 
mucus in the nose, throat and bronchi is lessened. Sweat, 
milk, pancreatic juice, bile, and the secretion of the stomach 
and intestines are all lessened. 

Action on the involuntary muscles: Stramonium lessens 
the contractions of all the involuntary muscles, such as the 
muscles of the stomach, intestines and bladder. 

It lessens particularly the contractions of the involuntary 
muscles of the bronchi. It is frequently used for this purpose, 
to relieve an attack of asthma by relaxing the involuntary 
muscles of the bronchi, the contractions of which cause the 
attack. 

Action on the pupil: Stramonium dilates the pupil, like 
atropine. 

Excretion 

Stramonium is excreted mainly by the kidney. 

Poisonous Effects 

Overdoses of stramonium produce the same effects as 
atropine poisoning. The characteristic symptoms are the 
dilated pupils, the dryness of the mouth and throat, the 
flushed skin, the rapid pulse which has a tendency to become 
intermittent, the rapid breathing, restlessness, talkative 
delirium, stupor, coma and death. The treatment is the 
same as for atropine poisoning. 

Uses 

Stramonium is often used to relieve spasmodic asthma. 



260 MATERIA MEDICA 

It is given in the form of cigarettes, which are smoked during 
the attack, or the leaves are burnt and the smoke inhaled. 
It relieves the attack by relaxing the spasm of the involun- 
tary muscles of the bronchi. 

Preparations 

Stramonium leaves made up in the form of cigarettes, or 
the plain dried leaves. 

Extract of Stramonium 0.015-0.03 gm.gr. ^-i 

(Extractum Stramonii) 

Fluidextract of Stramonium 0.06 -0.12 c.c. m. i-ii 

(Fluidextractum Stramonii) 

Tincture of Stramonium 0.3 -1.0 c.c. m. v-xv 

(Tmctura Stramonii) 

Stramonium Ointment 
(Unguentum Stramonii) 

This contains 10% of the extract of stramonium. It is 
used principally for painful haemorrhoids. 

HYOSCYAMUS 

Hyoscyamus is obtained from the leaves and flowering 
tops of Hyoscyamus niger or henbane, when the plant is two 
years old. It grows best in England, but it has been success- 
fully cultivated in the United States. Its active principles 
are the alkaloids hyoscyamine, hyoscine and small quantities 
of atropine. 

Hyoscyamine and hyoscine are chemically very much like 
atropine. 

The effects of hyoscyamus are quite similar to those of 
belladonna and atropine, except that it does not cause such 
increased activity of the brain. This is due to the hyoscine 
which it contains. This produces sleep and therefore lessens 
the excitement. 

Appearance of the Patient 

After administering hyoscyamus, the appearance of the 
patient is the same as after atropine. 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 261 

ACTION 

Local action: Applied to the skin, it relieves pain on the 
region where it is applied and checks the secretion of sweat. 
On mucous membranes : It checks the secretions. 

Internal Action 

In the mouth: It has a bitter taste and it checks the secre- 
tion of saliva. 

In the stomach and intestines: The secretion of gastric and 
intestinal juices is lessened. The digestion of food is there- 
fore retarded. The peristaltic contractions of the stomach 
and intestines are also lessened by hyoscyamus. 

Action after Absorption 

Hyoscyamus is rapidly absorbed from the stomach. 
After absorption it affects principally the heart, the res- 
piration, the brain, all the secretory glands, the involuntary 
muscles and the pupil. 

Action on the heart: Hyoscyamus makes the heart beat 
stronger and faster. More blood is therefore expelled by the 
contractions of the heart, and with greater force. The 
pulse is therefore rapid and strong. It is not as rapid, how- 
ever as after atropine. 

Action on the respiration: Hyoscyamus makes the breathing 
faster and deeper. 

Action on the brain: The effects of hyoscyamus on the 
brain differ somewhat from those of atropine. On account 
of the greater amount of hyoscine contained in hyoscyamus, 
the patient is less active and talkative, and does not move 
about as much as after atropine. There is a tendency to 
lessen the activity of the brain, so that very often sleep is 
produced because of the contained hyoscine, which lessens 
the activity of the brain. 

Action on the secretory glands: The secretion of all the 
secretory glands is lessened by hyoscyamus, in the same way 
as with atropine. There is therefore less saliva, less pancre- 
atic juice, less gastric juice, and less bile secreted. The 
secretion of mucus in the nose, mouth and throat and the 
secretion of sweat and milk are all diminished. 



262 MATERIA MEDICA 

Action on the involuntary muscles: Hyoscyamus lessens the 
contractions of involuntary muscles. This effect is almost 
twice as strong as from atropine. It is used particularly for 
this purpose to relax the spasm of the sphincter muscle at the 
neck of the bladder, which often causes painful urination. 

Action on the pupil: Hyoscyamus dilates the pupil more 
slowly than atropine, and makes the patient unable to see 
near objects distinctly, in the same way as atropine does. 

Excretion 
Hyoscyamus is rapidly excreted, mainly by the kidneys. 

Poisonous Effects 

The poisonous effects of hyoscyamus are the same as those 
of atropine. (See atropine poisoning.) The dry mouth, 
thirst, dilated pupils, rapid pulse, and breathing, and the 
delirium are the characteristic symptoms. The treatment 
is the same as for atropine poisoning. 

Preparations 

Extract of Hyoscyamus 0.03-0.2 gm. grs. ^-iii 

(Extractum Hyoscyami) 

Fluidextract of Hyoscyamus 0.3 -1.0 c.c. m. v-xv 

(Fluidextractum Hyoscyami) 

Tincture of Hyoscyamus 1.0 -1.0 c.c. m. xv-3i 

(Tinctura Hyoscyami) 

HYOSCYAMINE 

Hyoscyamine is very rarely used. Its effects are the same 
as those of atropine, to which it is very closely related. It 
lessens the contractions of all the involuntary muscles more 
than atropine. 

Preparations 

Hyoscyamine Sulphate 0.0005-0.001 gm. gr. 1 ^ lr - ^V 

(Hyoscyaminae Sulphas) 

Hyoscyamine Hydrobromide 0.0005-0.001 gm. gr. ^ - ^V 
(Hyoscyaminae Hydrobromidum) 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 263 

HYOSCINE OR SCOPOLAMINE 
Appearance of the Patient 

About a half to one hour after the administration of 
hyoscine, the patient feels tired and drowsy. He becomes 
less active, less talkative and soon falls asleep. The sleep 
resembles the normal sleep, and lasts from about five to 
eight hours, though the patient may feel drowsy for some 
time after that. The pulse and breathing are slow, and the 
pupils are dilated. When the patient awakes, he usually 
complains of dryness of the throat and mouth, and is very 
thirsty. 

Hyoscine produces sleep more easily, if the room is dark- 
ened and loud noises avoided. 

ACTION 

The action of hyoscine resembles that of atropine with 
the following differences: 

1. Action on the pupil: It dilates the pupil more rapidly 
than atropine, but the effects last for only a short time. 

2. Action on the heart: It makes the heart beat slower. 
The pulse is therefore slower after hyoscine. 

3. Action on the respiration: Hyoscine makes the breath- 
ing slower. 

4. Action on the brain: The activity of the brain is less- 
ened by hyoscine. It produces sleep, by lessening the action 
of the sensory areas of the brain. Fewer sensory impres- 
sions are then received, consciousness is therefore lessened 
and sleep produced. 

The action of the motor and speech areas of the brain 
is also lessened. The patient then feels tired, because he is 
less active and less talkative. 

Occasionally, there is a short period of excitement before 
the patient falls asleep. The patient may then feel dizzy 
and be quite active, though his movements are uncertain; 
and his speech becomes difficult and uncertain. 

Excretion 
Hyoscine is excreted mainly by the kidneys, more rapidly 
than atropine; usually in about eight to ten hours. 



264 MATERIA MEDICA 

Tolerance 

Patients may get used to hyoscine, so that large doses 
may be given without producing any effects. 

Poisonous Effects 

The poisonous effects of hyoscine are similar to those of 
atropine. The patient has the characteristic symptoms of 
wild talkative delirium, dryness of the throat and mouth, dilated 
pupils, dry red skin, rapid pulse and breathing, etc. 

Uses 

Hyoscine is usually given hypodermically, to produce 
sleep; especially in cases of delirium, mania, delirium tremens, 
etc. 

Hyoscine or scopolamine is often given together with 
morphine to produce a state of mild unconsciousness and 
anaesthesia, so that the surgeon is often enabled to perform 
an operation, such as the amputation of a limb, while the 
patient is under the influence of these drugs. It is also 
occasionally given before an anaesthetic is administered to 
lessen the time of anaesthesia. 

Preparations 

Hyoscine Hydrobromide 0.0003-0.0006 gm. gr. t J-q - ih 
(Hyoscinae Hyodrobromidum) 

Scopolamine Hydrobromide 
(Scopolaminae Hydrobromidum) 

This is the same as hyoscine hydrobromide. 

Euscopole (not official) 0.0003 gm. gr. ^hj 

This has a milder action than scopolamine. 

SCOPOLA 

Scopola is obtained from the underground stems of the 
Scopola atropoides, a plant which grows on the hills of 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 265 

central and southern Europe. Its active principles are the 
alkaloids atropine, hyoscyamine, and hyoscine or scopolamine. 

ACTION 

The action of scopola resembles that of hyoscyamus. 

It checks all secretions and lessens the contractions of all 
involuntary muscles. 

It makes the heart beat faster and stronger, and the 
breathing faster and deeper. 

It dilates the pupil. It has a soothing effect on the brain, 
producing sleep. It causes excitement and delirium only in 
poisonous doses. 

Uses 

It is occasionally used as a substitute for belladonna. 



Preparations 



*-* 



Extract of Scopola 0.015-0.03 gm. gr. -} 

(Extractum Scopolae) 

Fluidextract of Scopola 0.06 -0.12 c.c. m. i-ii 

(Fluidextractum Scopolae) 

Scopolamine hydrobromide is the same as hyoscine hydrobro- 
mide and is given in doses of 0.0003-0.0006 gm. gr. -^-j^ - ito- 



DUBOISIA 

Duboisia is obtained from the Duboisia myoporoides, an 
Australian shrub. Its active principle is duboisine, an alka- 
loid which at one time consists of hyoscyamine and at other 
times of hyoscine. It is used to soothe excitement of the 
brain. Its action is like that of hyoscyamus. It is not often 
used. 

MANDRAGORA (MANDRAKE) 

Mandragora is obtained from the Atropa mandragora, or 
Mandrogora autumnalis or mandrake. Its active principles 
are hyoscine, and other alkaloids. It resembles hyoscyamus 
in its action. It is rarely used. 



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DRUGS WHICH STIMULATE NERVOUS SYSTEM 267 



COCA AND COCAINE 

Coca is obtained from the dried leaves of the Erythroxylon 
coca, a shrub growing in Peru, Bolivia and other South 
American countries. It is now also cultivated in India, 
Java and Ceylon. 

The coca leaves are extensively used by the natives of 
South America. They chew it particularly when they have 
hard work to do, as they then do not tire easily, and it 
lessens their hunger. 

The active principle of coca is an alkaloid cocaine. In 
the Java coca, in addition to the cocaine, another alkaloid 
is present, tropacocaine. Cocaine is easily decomposed and 
various artificial combinations of it are made; such as coca- 
mine, isococamine, etc. 

The effects of the coca leaves are due principally to the 
cocaine which it contains. In practical medicine, the prepa- 
rations of the alkaloid cocaine are principally used. 

Appearance of the Patient 

A hypodermic injection of an average dose of cocaine, or if 
it is applied to the mucous membranes, usually produces in- 
sensibility to pain on the area where it is injected or applied. 
As soon as the cocaine is absorbed, usually in ten or fifteen 
minutes, the patient becomes restless, somewhat more active, 
and more talkative. He usually feels happy and joyful. 
The patient often complains of headache, dryness of the 
throat, the pulse is rapid, strong and small, the breathing 
is rapid and deep, and the pupils are dilated. 

ACTION 

Local action: Applied to the skin, cocaine produces no 
effects, but if it is injected under the skin, or applied to a 
wounded surface, it relieves pain. If it is injected into a 
nerve, it lessens pain in the area of skin from which the nerve 
fibers come. 

On mucous membranes: Cocaine relieves pain and makes 
the membrane very pale and thin, by contracting its blood 



268 MATERIA MEDICA 

vessels. It also checks bleeding by contracting the blood 
vessels. 

The insensibility to pain, or anaesthesia, produced by 
cocaine, lasts only for a short time; for about fifteen 
minutes to a half hour, depending on the strength of the 
solution used. As soon as the cocaine is absorbed, the an- 
aesthesia and pallor disappear. Cocaine produces insensi- 
bility to pain by paralyzing the nerve endings, in the skin or 
mucous membranes, which receive impressions of pain. 

The mucous membrane of the eye, nose, pharynx, larynx, 
oesophagus, stomach, urethra, bladder, vagina and rec- 
tum, are all affected in this way, if cocaine is applied di- 
rectly to these mucous membranes, and it is absorbed from 
all of them. In the nose, in addition to the effects on 
the mucous membrane, it lessens the sense of smell, by 
paralyzing the nerve endings which receive impressions of 
smell. 

Internal Action 

In the mouth: Cocaine has a bitter taste for a short time, 
as it soon paralyzes the nerve endings in the tongue which 
appreciate bitter substances. It also lessens pain on the 
mucous membrane of the mouth, and contracts its blood 
vessels. 

In the stomach : Cocaine acts as a local anaesthetic, and it 
contracts the blood vessels of the mucous membrane. It 
often lessens vomiting and hiccough, by paralyzing the nerve 
endings in the stomach, so that no impulses can reach the 
brain, to cause vomiting or hiccough. 

Action on the intestines: Since cocaine is so rapidly ab- 
sorbed from the stomach, it affects the intestines only after 
absorption. It increases the peristalsis, causing more fre- 
quent movements of the bowels. 



Action after Absorption 

Cocaine is very rapidly absorbed into the blood from all 
mucous membranes, and from any region of the body where 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 269 

it may be injected; usually in about ten or fifteen minutes. 
After absorption it affects principally the circulation, the 
respiration, the brain, the pupil, the kidney, and slightly 
the muscles. 

Action on the circulation: On the heart: Cocaine makes the 
heart beat stronger and faster. It increases the contractions 
of the heart muscle, and it also causes the cardio accelerator 
center in the medulla of the brain, to send more impulses to 
the heart to make it beat faster. 

On the blood vessels: Cocaine makes the blood vessels 
narrower, by contracting the fine muscle fibers in their walls, 
and increasing the impulses for their contraction, which are 
sent out from the vaso-motor center in the medulla of the 
brain. 

The total effect of cocaine on the circulation, is to make 
the heart beat stronger and faster, and to increase the blood 
pressure. The pulse is therefore rapid, strong, but small. 

Action on the respiration: Cocaine makes the breathing 
faster and deeper. 

Action on the brain: It increases the activity of every 
part of the brain. The patient is wakeful, and more suscepti- 
ble to receive impressions from his surroundings, as a result 
of the increased activity of the sensory areas of the brain. 
He is usually more active, and is able to do more work and 
with less fatigue. He can stand hunger for a longer time. 
The patient is more talkative. These effects are due to the 
increased activity of the motor and speech areas of the brain. 

The mental activities of the brain are also increased, so 
that all kinds of mental work such as reasoning, memory, 
etc., are performed better. 

The emotions are more active, especially the pleasant 
ones, and the patient is somewhat joyful and happy. 

Overdoses cause, at first, greatly increased activity of the 
brain, and then, from exhaustion, very much lessened ac- 
tivity (see poisonous effects). 

Action on the muscles : Cocaine slightly increases the con- 
tractions of all the muscles. 

Action on the pupil: It rapidly dilates the pupil, usually 
in about a half to one hour. It does not affect the sight for 



270 MATERIA MEDICA 

near and distant objects (accommodation). The effect 
wears off in about twenty-four hours. 

Action on the kidney: Cocaine increases the secretion of 
urine, as a result of its effect on the circulation, and the 
blood vessels of the kidneys. 

Excretion 

Cocaine is partly excreted by the urine, and partly de- 
stroyed in the body, 

Poisonous Effects 

Cocaine poisoning occurs in two forms, acute cocaine 
poisoning, and cocaine habit, or chronic cocaine poisoning. 



Acute Cocaine Poisoning 

Acute cocaine poisoning results from overdoses of cocaine 
injected hypodermically, or applied to mucous membranes 
for local anaesthesia. The symptoms are due to overactivity 
of the various organs of the body which cocaine affects, fol- 
lowed by exhaustion of these organs, which then produce 
symptoms of lessened activity or depression. The symptoms 
vary somewhat in different individuals. Some individuals 
are so susceptible to the drug that small doses may cause 
poisonous effects. 

Symptoms 

1. Usually the patient becomes quite talkative, happy and 
jolly, though he may be somewhat confused in his speech 
and ideas. 

2. He is quite active and moves about a great deal. 

3. The pulse is very rapid and small, and the breathing is 
very rapid. 

4. The skin is pale, and covered with sweat. 

5. The pupils are widely dilated. 

6. Occasionally there may be vomiting. 

Soon the delirium becomes more marked, the patient may 
see objects about him, he may have muscular contractions of 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 271 

the hands and feet, which are soon followed by either clonic 
or tonic convulsions, more often clonic. The pulse becomes 
very rapid, intermittent and weak, and the breathing soon 
becomes shallow. The skin is blue and cold, though the tem- 
perature may be increased, and the pupils are widely dilated. 
Soon the convulsions increase. The pulse becomes slow 
and weak, the breathing very shallow and irregular, and the 
patient dies from paralysis of respiration, but is conscious 
to the very last. At times there may be no convulsions 
and no excitement, but the patient soon dies of collapse. 
At other times the patient may be maniacal. 

Treatment 

1. If the cocaine has been taken by mouth, the stomach 
should be washed out. 

2. The best drug which antagonizes the action of cocaine, 
is amyl nitrite given by inhalation, or nitroglycerin, given 
hypodermically. This lessens the overacting heart and res- 
piration. 

3. For the convulsions and delirium, inhalations of chloro- 
form should be given. 

4. To prevent the convulsions from returning, chloral, 
opium, or morphine should be given. 

5. The collapse should be treated by artificial respiration 
and cardiac stimulants, such as ammonia, whiskey, caffeine, 
etc. 

COCAINE HABIT OR CHRONIC COCAINE POISONING 

The cocaine habit is unfortunately very common, and is 
often induced by its beneficial effects in the nose for the relief 
of hay fever, catarrh, etc., often from its use as a substitute 
for morphine. It is usually taken in the form of a powder or 
liquid, which is snuffed up in the nose. Many of the cocaine 
habitues are also addicted to the use of other habit-forming 
drugs, such as morphine, etc. The symptoms of the cocaine 
habit are most pernicious, and are responsible for many 
ruined lives. 



272 MATERIA MEDICA 

Symptoms 

The earliest symptoms resulting from the continued use 
of cocaine are various digestive disorders; loss of appetite, 
foul breath, excessive flow of saliva and loss of weight. The 
patient is dull and listless, his gait is uncertain and his eyes 
are sunken. Soon the patient suffers from sleeplessness, 
frequently he has tremors of the muscles of the face and hands, 
and occasionally convulsions. He is careless about his person 
and his actions, and he has no will power. Very often he has 
delirium and hallucinations and even various forms of in- 
sanity may develop. Sometimes ascites (fluid in the abdo- 
men) develops and death may result from great wasting. 

When the cocaine is stopped, these symptoms gradually 
disappear. 

Uses 

Cocaine is used principally as a local anaesthetic. Many 
surgical operations can thus be performed after it is injected 
into the region to be operated upon, or when it is applied to 
the mucous membranes. It is extensively used in nose and 
throat operations. The poisonous symptoms of cocaine, 
which result from its absorption, can often be avoided by 
using a solution of cocaine, together with adrenalin; the adre- 
nalin contracts the blood vessels and thereby lessens the 
absorption. 

It is also used to relieve colds in the nose (acute coryza), 
and to check vomiting and hiccough. 

Preparations 
Coca 

Fluidextract of Coca 2.0-4.0 c.c. 3f-i 

(Fluidextractum Cocae) 

Wine of Coca 4.0-16.0 c.c. . 5i~5i 

(Vinum Cocae) 

Cocaine 

Cocaine 0.008-0.03 gm. gr. i - 1 

(Cocaina) 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 273 

This is seldom used because it does not dissolve very 
easily in water. 

Cocaine Hydrochloride 0.008-0.03 gm. gr. -J - \ 

(Cocainae Hydrochloridum) 

For local applications, watery solutions are used in 
strengths varying from \% to 10%. For nose and throat 
work 20% solutions are often used, or even the powdered 
cocaine dissolved in adrenalin solution may be used. 

The amount of cocaine used to produce local anaesthesia 
varies with the strength of the solution. The total amount 
injected should never contain more than the average dose 
of cocaine, \ to \ grain, no matter what strength of solu- 
tion may be used. Poisonous symptoms are thus avoided. 

There are a number of artificial alkaloids, which resemble 
cocaine in its action, and are used as local anaesthetics. The 
most important of these are eucaine, tropococaine, holocaine, 
stovaine, alypin, etc. Their action will be considered later, 
under local anaesthetics. 

Eupthalmin (Not official) 

This is an artificial alkaloid which is used in 2% solutions 
to dilate the pupils. It does not affect the circulation. 



NUX VOMICA AND STRYCHNINE 

Nux vomica is obtained from the seeds of the Strychnos 
mix vomica, and Strychnos ignatia, a middle sized tree, grow- 
ing in the East Indies. These seeds are round, flat discs 
about the size of a five cent piece, and are often called 
poisoned nut or quaker buttons, because they resemble gray 
buttons. 

The active principles are two alkaloids, strychnine and 
brucine. The effects of both of these are the same; brucine 
being half as strong as strychnine. It also contains an acid, 
igasuric acie. 

The action of nux vomica is due to the strychnine which 
it contains, so that the effects of the drug are the same as 
those of its active principle. 



274 MATERIA MEDICA 

Appearance of the Patient 

When strychnine or a preparation of mix vomica is 
given, the patient complains of its very bitter taste. The 
appetite is increased and digestion is better. The patient 
feels stronger and more hopeful. The pulse is slower and 
stronger, and the breathing is deeper and faster. 

All the sensations are better appreciated. The sight is 
better and the hearing is more acute. The sense of touch 
is more delicate. The body responds quicker and more 
vigorously to all impressions received through the various 
senses. These effects are often only noticed when the drug 
is given continuously for some time. 

ACTION 

Local action: No effects are produced when either nux 
vomica or strychnine are applied to the skin or mucous 
membranes. 

Internal Action 

In the mouth: Strychnine has a very bitter taste. It is 
one of the bitterest substances known; a 1-20,000 solution 
gives an extremely bitter taste. Because of this bitter taste, 
it increases the appetite and the flow of saliva. 

In the stomach: Strychnine increases the secretion of 
gastric juice, and the peristalsis of the muscle wall of the 
stomach. The digestion is thus aided, and the food is quickly 
passed on to the intestines. 

In the intestines: It increases the secretion of the mucous 
membranes and the peristalsis. Frequent movements of the 
bowels then result. 

The increased peristalsis of the stomach and intestines pro- 
duced by strychnine, is due to its effect on the mucous mem- 
brane of these organs, and to its action on the spinal cord. 
The effect on the mucous membranes, sends impulses to the 
spinal cord, which is made more active by strychnine. 
The spinal cord then sends out more and faster impulses to 
contract the muscles of the stomach and intestines. 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 275 

Action after Absorption 

Strychnine is absorbed into the blood mainly from the 
intestines, in about one or two hours. After absorption, it 
affects principally the circulation, the respiration, and the 
spinal cord. 

Action on the circulation: On the heart: Strychnine makes 
the heart beat slower, by sending more impulses from the 
vagus or inhibitory center in the medulla, to make the heart 
beat slower. 

On the blood vessels: It makes the blood vessels narrower; 
especially the blood vessels in the abdomen. This is due 
to the effect on the vaso-motor center in the medulla, an 
area of gray matter which sends out impulses to control 
the width of the blood vessels. Strychnine makes this center 
more active. More impulses are then sent to the muscle 
fibers in the walls of the blood vessels to make them contract. 
The blood vessels then become narrower, and offer a greater 
resistance to the contractions of the heart, which then beats 
stronger. The blood pressure is also increased by the con- 
traction of the blood vessels. 

The total effect of strychnine on the circulation is there- 
fore to make the heart beat slower and stronger. The character- 
istic strychnine pulse is slow and strong. 

Action on the respiration: The breathing is deeper and 
faster because of the increased impulses for breathing sent 
out by the respiratory center in the medulla. 

Action on the nervous system: Strychnine does not affect 
the brain. 

Action on the sensations: Strychnine increases the appre- 
ciation of all the various sensations. The patient is able to 
see and to hear somewhat better, and to appreciate various 
objects better through the sense of touch. 

Action on the spinal cord: This is the most important 
action of strychnine. Most of the strychnine effects result 
from its action on the spinal cord and the medulla. 

It increases the activity of all the cells of the gray matter 
of the spinal cord and the medulla oblongata. As a result 
of this action, all the activities of the body which are due to 



276 MATERIA MEDICA 

impulses received through the various senses, are increased 
(reflex action). 

In this way, strychnine acts as a tonic, improving the 
activity of every part of the body. The patient responds 
better and quicker to all the impressions received through 
the various senses. He is therefore somewhat brighter, and 
his muscles contract better, because they respond more easily, 
to impressions received through the various senses, so that 
the individual is able to do more work, after continued 
strychnine administration. 

The appetite and digestion are better, and the bowels 
move more often, because of the increased reflex action which 
makes the gastric and intestinal muscles respond more easily 
to any substance affecting their mucous membrane. 

The heart beats stronger, and the breathing is faster and 
deeper. 

As a result of all these effects on the various organs of the 
body, the patient feels stronger, healthier and more robust. 

Excretion 

Strychnine is excreted mainly by the kidneys, though very 
slowly. It takes about three to seven days for the drug 
to be entirely excreted. 

Poisonous Effects 

Strychnine poisoning occurs in two forms; acute strych- 
nine poisoning and chronic strychnine poisoning, or cumula- 
tive effects. 

Acute Strychnine Poisoning 

Acute strychnine poisoning usually results from giving 
an overdose of strychnine, or when it is taken with suicidal 
intent. The symptoms appear very soon after it is taken, 
usually in about fifteen minutes. 

Symptoms 

1. The patient first complains of stiffness of the muscles 
of the neck or face, and of slight stiffness of the jaw. 

2. Soon a slight touch or gust of air in the room or even 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 277 

a slight sound will cause a violent twitching of the face or 
arms. 

3. This is accompanied by restlessness and slight move- 
ment of the face and muscles of the arms. 

4. Sudden tetanic convulsions of the whole body then occur. 
The arms and legs are rigid and extended. The head is 
drawn back, and the back is bent so that it forms a concavity 
(opisthotonus). The contractions of the facial muscles 
draw up the corners of the mouth, causing a peculiar grin 
and ghastly expression known as the "risus sardonicus." 

The convulsions are due to the increased reflex action; and 
are brought on by the slightest stimulus, such as a gust of 
air, the touch of a blanket, etc. After the convulsion, all 
the muscles are relaxed, but the slightest touch or a gust 
of wind, or a loud noise, at once produces another paroxysm. 

5. The contractions of the muscles of the diaphragm, 
during the convulsions, give the face and lips a blue color, 
from the lack of oxygen in the blood, due to the interference 
with the breathing. 

6. The pulse is slow and stronger, but during the convulsions 
it is often rapid. 

7. The convulsions then become more frequent, and the 
patient finally dies of asphyxia, in about two or three hours; 
the mind remaining clear to the end. 

These symptoms of strychnine poisoning are all due to its 
effect on the spinal cord. The activity of the gray matter 
of the cord is increased so much, that even the slightest 
stimulus causes such a marked response, so many impulses 
being sent out from the cord, that violent contractions of all 
the muscles of the body, or convulsions result. In a normal 
individual, however, an external stimulus such as touching 
the skin, etc., sends an impulse to the spinal cord which re- 
sults in the contraction of only one, or of a number of muscles; 
so as to take the arm or leg away from the stimulus. 

Treatment 

1. Give tannic acid to combine with the strychnine. 

2. Wash out the stomach or give emetics if strychnine 
has been taken by the mouth. 



278 MATERIA MEDICA 

3. If the patient has convulsions, give chloroform or ether 
to control them, and then wash out the stomach. 

4. To prevent the convulsions from returning, give chloral 
or bromides repeatedly. 

5. Catheterize the bladder to prevent reabsorption of 
the strychnine in the urine. 

6. Give artificial respiration and oxygen when the patient 
is blue and cyanotic. 

Cumulative Action or Chronic Strychnine Poisoning 

Since strychnine is rapidly absorbed and very slowly 
excreted, some of it always remains in the body if it is given 
continuously, and often causes cumulative symptoms. 
These symptoms, which result from the accumulation of 
strychnine in the body, are the same as the acute symptoms, 
but they develop more slowly. 

Symptoms 

1. The earliest symptoms which indicate that the patient 
is getting too much strychnine, are twitching of the muscles 
of the face or of the extremities, which may follow the slightest 
touch. 

2. Often the earliest symptom may be diarrhoea. 

3. Soon the patient complains of stiffness of the neck 
and jaw. 

If the drug is continued, convulsions may occur. 

Treatment 

1. Stop the drug as soon as the earliest symptoms are 
noticed. This allows the strychnine in the body to be ex- 
creted, and further symptoms are avoided. If other symp- 
toms occur, the treatment is the same as for acute poisoning. 

Uses 

Strychnine is used principally: 

1. As a heart and respiratory stimulant in collapse. 

2. In various forms of paralysis, to increase the contrac- 
tions of the muscles. 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 279 

3. As a tonic, to improve the general health and strength 
of the body. 

4. To increase the appetite and to improve the action of 
the bowels. 

Administration 

For rapid effect in collapse, strychnine should be given 
hypodermically. 

To increase the appetite, mix vomica is usually given be- 
fore meals. 

Preparations 

Nux Vomica 
Solid Preparations: 

Extract of Nux Vomica 0.015-0.06 gm. gr. i-i 

(Extractum Nucis Vomicae) 

Fluid Preparations: 

Fluidextract of Nux Vomica 0.06 -0.3 c.c. m. i-v 

(Fluidextractum Nucis Vomicae) 

Tincture of Nux Vomica 0.3 -1.0 c.c. m. v-xv 

(Tinctura Nucis Vomicae) 

This is the preparation most frequently used as a tonic. 

Strychnine 

Strychnine 0.002-0.004 gm. gr. ^ - tV 

(Strychnina) 

Strychnine Sulphate 0.002-0.004 gm. gr. A-iV 

(Strychninae Sulphas) 

This is the preparation used hypodermically in collapse. 
In fluid form, it is most often used in a 1% solution. 

Strychnine Nitrate 0.002-0.004 gm. gr. ^ - £ 

(Strychninae Nitras) 

Iron and Strychnine Citrate 0.06 -0.2 gm. gr. i-iii 
(Ferri et Strychninae Citras) 

Syrup of Iron, Quinine and Strychnine Phosphate 

4.0 -8.0 c.c. 3i-ii 
(Syrupus Ferri, Quininae et Strychninae Phosphatum) 



280 MATERIA MEDICA 

This contains ■& of a grain of strychnine in each dose of 
5i. 

Elixir of Iron, Quinine and Strychnine Phosphate 

4.0-8.0 c c. 3i~ii 

(Elixir Ferri, Quininae et Strychninae Phosphatum) 

It contains wi of a grain of strychnine in each 3i dose. 

PICROTOXIN (not official) 

Picrotoxin is a neutral substance obtained from the fruit 
or fish berries, of Anamirta paniculata, a plant growing in 
Asia. 

There are a number of similar substances found in various 
plants which produce the same effects as picrotoxin. The 
most common of these are : 

Cicutoxin, the active principle of Cicuta virosa or water 
hemlock. 

Oenanthotoxin, the active principle of Oenanthe crocata or 
water dropwort or dead tongue. 

Phytolaccotoxin, the active principle of Phytolacca or poke 
root, a Japanese plant. 

When a number of the active glucosides of digitalis are 
decomposed, they form substances which act like picrotoxin. 
For example: 

Digitoxin forms toxiresin. 

Digitalin forms digitaliresin. 

ACTION 

Picrotoxin acts very much like strychnine. Its principal 
effects are: 

1. Nausea and vomiting. 

2. Slow, strong pulse. 

3. Rapid deep breathing. 
In overdoses it causes: 

1. Stupor, and unconsciousness, followed by: 

2. Muscular twitchings. 

3. Delirium. 

4. Clonic convulsions. 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 281 

Uses 

It has been used locally in the form of an ointment to 
destroy pediculi, and for other skin diseases. 

Preparations 
Picrotoxin 0.001-0.003 gm. gr. bV-itV 



PHYTOLACCA 

Phytolacca is obtained from the berries and roots, of 
Phytolacca decandra, a Japanese plant. Its active principle 
is phytolaccotoxin, which produces the same effects as picro- 
toxin. 

Uses 

It is used locally in various skin diseases. It is also said 
to reduce fat and is an ingredient of many anti fat remedies. 

Preparations 

Fluidextract of Phytolacca 0.3-2.0 c.c. m. v-xxx 

(Fluidextractum Phytolaccae) 



CEREBRAL TONICS 

The following drugs increase the activity of the nervous 
system, by improving the nutrition of the brain and spinal 
cord. 

PHOSPHORUS 

Phosphorus is a non-metallic element obtained from bones 
by the action of sulphuric acid and water. It is a semi- 
solid, soft, wax like, colorless or yellowish substance, which 
emits light in the dark, and has an odor of garlic. 

Phosphorus is found in the body in many tissues, espe- 
cially in nervous tissue and bone. In the nervous tissues, 
phosphorus is present in large quantities combined with 
fats. They are called lecithins, or phosphorized fats. In 
the bones, phosphorus is present combined with calcium, 
sodium, or magnesium. It is also contained in many foods 
such as vegetables. 

Appearance of the Patient 

When oily preparations of phosphorus are given for some 
time, to patients suffering from neurasthenia, or other nerv- 
ous diseases, the patient usually becomes more quiet, he 
is not as nervous and his mental activ'ty Is better. The 
appetite is better, the pulse is stronger, he breathes better 
and somewhat faster, and feels healthier, stronger and more 
robust. 

ACTION 

The action of phosphorus is quite similar to that of 
arsenic. 

Local action: Applied to the skin, phosphorus causes in- 
flammation, often the skin is destroyed, leaving an ulcer. 
On mucous membranes: It causes redness, swelling and 
inflammation. 

Internal Action 

In the mouth: Except for the slight redness of the mucous 
membrane, no effects are produced. 

282 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 283 

In the stomach : It increases the appetite, and the secretion 
of gastric juice, thus aiding digestion. 

In the intestines: It causes increased secretion of the 
mucous membrane, thereby often producing frequent move- 
ments of the bowels. 



Action after Absorption 

Phosphorus is very slowly absorbed into the blood from 
the stomach. It is absorbed only from oily solutions, or 
when combined with glycerin in the form of glycerophos- 
phates. It is also absorbed by the mucous membrane of the 
lungs when its fumes are inhaled. After absorption, it 
affects principally the nervous tissues, the bones and slightly 
the blood, heart and kidneys. 

Action on the nervous tissues: Phosphorus slightly in- 
creases the activity of all the cells of the brain and spinal 
cord by improving their nutrition. It combines with the 
fats absorbed from the food, and forms lecithin, a substance 
which is contained in nervous tissues. In this way, phos- 
phorus preparations, when given for a long time, will relieve 
many of the symptoms of neurasthenia, and "nervousness." 
These symptoms result from overwork or fatigue of the 
brain cells. 

Phosphorus preparations, by improving the nutrition of 
the brain cells, relieve the condition of nervousness and 
irritability, and make the patient calmer and more quiet. 
They slightly improve all his mental activities, and the 
patient is not as nervous in his actions and speech. 

Action on bone tissue: Phosphorus improves the nutri- 
tion of bone. It makes the spongy part of the bone firmer 
and harder, by improving the growth of the bone cells. 

Action on the blood : Small continued doses of phosphorus, 
increase the number of the red blood cells. 

Action on the heart: It makes the heart beat somewhat 
stronger and faster. The pulse, after continued use, is there- 
fore somewhat stronger and faster. 

Action on the secretory glands: Phosphorus sometimes in- 
creases the secretion of sweat. 



284 MATERIA MEDICA 

Action on the sexual organs: Many preparations of phos- 
phorus often increase the activity of the sexual organs. 

Action on the kidney: The flow of urine is somewhat 
increased by phosphorus. 

Excretion 

Phosphorus is slowly excreted, mostly by the kidney, by 
the intestines and the sweat, and also by all the mucous 
membranes, especially those of the lungs. 

Poisonous Effects 

Phosphorus poisoning occurs in two forms: Acute phos- 
phorus poisoning and chronic phosphorus poisoning. 

Acute Phosphorus Poisoning 

Acute phosphorus poisoning usually results from phos- 
phorus taken with suicidal intent. The red phosphorus is 
usually more poisonous than the yellow phosphorus. Many 
pastes used to destroy vermin, or match heads which con- 
tain phosphorus, are the substances usually taken for this 
purpose. 

The symptoms usually appear in about three to twelve 
hours after they are taken. If an oily solution, or a paste is 
taken, the symptoms appear more rapidly. If a solid prep- 
aration such as match heads are taken, the symptoms come 
on later. 

Symptoms 

Several hours after the phosphorus is taken, the patient 
complains of pain in the stomach. He has a garlic taste in his 
mouth, and a similar odor to the breath, and he feels nau- 
seated. Soon the patient begins to vomit continuously. The 
vomited matter has a characteristic garlic odor and emits light 
when it is held in the dark (phosphoresces). Later the 
vomited matter contains bile. If the amount of phosphorus 
taken has not been very large, and has mostly been vomited, 
the nausea and vomiting may continue for several days, 
without any further symptoms. 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 285 

Usually however, the symptoms return, but the vomited 
matter now contains blood, which is dark in color (coffee 
ground), the patient becomes jaundiced (yellow color of the 
skin), the pain spreads all over the abdomen, and the liver 
is enlarged. There is profuse diarrhoea, the stools often 
containing blood. There may also be bleeding from the nose, 
from the uterus and under the skin. The urine is often scanty 
and contains albumin. 

The patient is usually in severe collapse, because of the 
profuse vomiting and diarrhoea. He feels weak and faint, the 
pulse is rapid, weak and thready, the breathing is slow and 
shallow, and the skin is cold and moist. He gradually goes 
into coma and dies. Occasionally there are convulsions and 
delirium before death. 

Death from phosphorus poisoning has resulted from gr. 
| to grs. ii in a few hours to a few weeks. 

The characteristic symptoms of phosphorus poisoning are: 

1. Nausea, vomiting and diarrhoea. 

2. The vomitus and stools, as well as the urine emit light 
when held in the dark. 

3. Jaundice. 

All the symptoms of phosphorus poisoning are due to the 
destruction of many of the cells of the various organs of the 
body. The cell substances are destroyed, and changed into 
fat globules with which the cells are then filled. For example, 
the jaundice is due to the destroyed liver cells which block 
up the bile ducts in the liver, the bile is then secreted back 
into the blood. The vomiting and diarrhoea with bloody 
vomitus and bloody stools, are due to the destruction of the 
cells of the mucous membrane of the stomach and intestines. 

Treatment 

1. Give as an antidote, old common crude turpentine or, 
French acid turpentine, about 2.0 c.c. (3|) every fifteen 
minutes. This forms a hard solid mass with the phosphorus, 
and prevents its absorption. 

2. Occasionally hydrogen peroxide, or potassium per- 
manganate, may be given to oxidize the phosphorus. 

3. Copper sulphate may be given to produce vomiting. 



286 MATERIA MEDICA 

It is also an antidote, and is best given about two grains 
every five minutes, until vomiting is produced; and after 
that gr. \ may be given every twenty minutes as long as 
ordered. 

4. Wash out the stomach. 

5. Give cathartics, especially salines such as hydrated 
magnesia. 

6. Protect the mucous membrane with albuminous drinks 
as the white of egg, etc. 

7. Do not give oils or fats, as these hasten the absorption of 
the phosphorus. 

8. Treat the collapse with heart stimulants such as 
caffeine, strychnine, atropine, etc. 

Chronic Phosphorus Poisoning 

Chronic phosphorus poisoning usually occurs in individuals 
who work in phosphorus match factories, as a result of con- 
tinually inhaling the phosphorus fumes. It occurs most 
frequently from the use of the yellow phosphorus, which has 
now mostly been given up, and the symptoms are there- 
fore now rarely seen. 

Symptoms 

The symptoms usually begin with a carious tooth, or a 
sore gum. The gums become swollen and painful, abscesses 
of the jaw often form, with destruction of pieces of the jaw 
bone. Occasionally there may be slight jaundice, anaemia, 
diarrhoea, albumin in the urine, etc. 

Treatment 

Thorough ventilation of the factories where phosphorus 
is used, to get rid of the fumes, and the inhalation of the 
crude turpentine, usually prevents the condition. 

The abscesses of the jaw which form, must be treated 
surgically. 

Uses 
Phosphorus preparations, are used: 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 287 

1. In nervous diseases such as neurasthenia, and other 
similar diseases, to build up the nervous tissues. 

2. To harden the bones in rickets, osteomalacia, etc. 

3. To increase sexual activity. 

Preparations 

Phosphorus 0.0006-0.0012 gm. gr. T fo - z \ 

(Phosphorus) 

Pills of Phosphorus 
(Pilulae Phosphori) 

Each pill contains 0.0006 gm. (gr. T W of phosphorus. 
Phosphorated Oil 0.06 -0.3 c.c. m. i-v 

(Oleum Phosphori ) 

This contains about 1% of phosphorus in almond oil and 
ether, and is occasionally used. 

The following preparations are made from phosphoric 
acid; which is formed when phosphorus is burnt. 

Dilute Phosphoric Acid 0.3-1.0 c.c. m. v-xv 

(Acidum Phosphoricum Dilutum) 

This contains 10% of the pure phosphoric acid. 

From the phosphoric acid the following salts are obtained: 

Precipitated Calcium Phosphate 
(Calcii Phosphas Praecipitatus) 

This is rarely given alone, but in the form of an emulsion 
of cod liver oil and lactophosphate of calcium. Each drachm 
contains gr. ii of calcium phosphate and Z\ of cod liver 
oil. 

Zinc Phosphide 0.003-0.03 gm. gr. ■$$-% 

(Zinci Phosphidum) 

The following preparations are made from hypophosphorus 
acid, which is never used of itself. 

Calcium Hypophosphite 1.0-2.0 gms. grs. xv-xxx 

(Calcii Hypophosphis) 

Iron Hypophosphite 1.0-2.0 gms. grs. xv-xxx 

(Ferri Hypophosphis) 



288 MATERIA MEDICA 

Potassium Hypophosphite 1.0-2.0 gms. grs. xv-xxx 

(Potassii Hypophosphis) 

Sodium Hypophosphite 1.0-2.0 gms. grs. xv-xxx 

(Sodii Hypophosphis) 

Syrup of Hypophosphites 4.0-8.0 c.c. 5 i — ii 

(Syrupus Hypophosphitum) 

This contains the hypophosphite of calcium, sodium and 
potassium, also the tincture of lemon peel and sugar. 

Compound Syrup of Hypophos- 
phites 4.0-8.0 c.c. Si— ii 
(Syrupus Hypophosphitum Compositus) 

This contains iron hypophosphite in addition to the 
ingredients in the syrup of hypophosphite. 

The following preparations are made from glycerophos- 
phoric acid: 

Calcium Glycerophosphate 0.2-0.6 gm. grs. iii-x 

(Calcii Gylcerophosphas) 

Various syrups and wines of glycerophosphates are on the 
market. Many of them are combined with iron. They are 
all good tonics. 

GOLD (ATJRUM) 

Gold is a heavy metal: some of its salts are occasionally 
used in medicine. 

ACTION 

When given internally gold salts produce the following 
effects. 

1. They increase the appetite and aid digestion. 

2. They lessen nervousness in neurasthenia, making the 
patient calm and quiet, by improving the nutrition of the 
brain. 

3. They increase reflex action. 

4. They increase the secretion of sweat. 

5. They often increase the flow of urine. 

6. Gold salts are said to increase menstruation, and sexual 
activity. 



DRUGS WHICH STIMULATE NERVOUS SYSTEM 289 

Poisonous Effects 

Overdoses cause: 

1. Abdominal pain. 

2. Nausea, vomiting and diarrhoea, with bloody vomitus 
and bloody stools. 

3. Collapse. 

Continued use of gold salts often causes loss of appetite, 
poor digestion, and wasting. 

Uses 

Gold salts are principally used to lessen nervousness, in 
hysteria and neurasthenia, and as a substitute for mercury 
in the treatment of syphilis. It was formerly used in the 
treatment of the alcohol habit. The "Keely Cure" was a 
treatment of alcoholism with the bichloride of gold, a salt 
which does not exist. 

Preparations 

Gold and Sodium Chloride 0.006 -0.03 gm. gr. T V--| 

(Auri et Sodii Chloridum) 

Gold Chloride 0.0004 gm. gr. T fr 

(Auri Chloridi) 

Gold and Potassium Bromide 0.01-0.04 gm. gr. i - f 
(Auri et Potassii Bromidum) 

This is usually given hypodermically. The injections are 
painful and often cause pain around the heart. 



CHAPTER XI 

ALTERATIVES 

Alteratives are drugs which improve the nutrition of the 
body, or various organs of the body. Their mode of action 
is unknown. They are said to improve the condition of 
the blood. 

Drugs which improve the condition of the blood such as 
iron or arsenic, also thereby improve the nutrition of the 
body. The drugs which improve the nutrition of the nervous 
system also improve the nutrition of various parts of the 
body. Most of these drugs however, have other important 
actions and have been described under these effects. 

The most important drugs which are occasionally used 
as alteratives are: 

Mercury. 

Gold. 

Iodine and salts of hydriodic acid such as potassium 
iodide, sodium iodide, etc. 

Arsenic. 

The following drugs are rarely used, but when given, they 
are used only as alteratives. 

SARSAPARILLA 

Sarsaparilla is obtained from the roots of Smilax offici- 
nalis, and other varieties of smilax. It is a prickly vine 
obtained from Mexico, Honduras, Brazil and other coun- 
tries in the northern part of South America. Its active 
principles are soapy glucosides (saponins). Sarsaponin, 
sarsaparilla saponin, parillin and smilacin. The amount of 
these glucosides however, is not sufficient to cause a marked 
effect. 

290 



ALTERATIVES 291 

ACTION 

Sarsaparilla is used principally to improve the nutrition 
of the body (alterative). It is said to increase the perspira- 
tion. In large doses it causes vomiting and diarrhoea. It 
was formerly used a great deal in the treatment of the third 
stage of syphilis, chronic rheumatism, etc. It is occasionally 
used as a drink. 

Preparations 

Fluidextract of Sarsaparilla 4.0 c.c. 5i 

(Fluidextractum Sarsaparillae) 

Compound Fluidextract of 

Sarsaparilla 4.0-8.0 c.c. 5i-ii 

(Fluidextractum Sarsaparillae Compositus) 

This contains sarsaparilla, licorice root, sassafras and 
mezereum. 

Compound Syrup of Sarsa- 
parilla 15.0-30.0 c.c. SH 
(Syrupus Sarsaparillae Compositus) 

This is used as an excellent vehicle in which to give 
potassium iodide. 

GUIAC RESIN (GUIACUM RESINA) 

Guiacum is the resin of the wood of guiacum officinale 
and guiacum sanctum, evergreen trees of South America. 

ACTION 

Guiac is said to improve the nutrition of the body, to 
increase the secretion of sweat and the mucous membranes. 

Overdoses cause vomiting and diarrhoea. 

It is occasionally used in syphilis, tonsilitis, and is often 
given to increase the menstruation. 

Preparations 

Tincture of Guiac 2.0-8.0 c.c. 5^-ii 

(Tinctura Guiaci) 



292 MATERIA MEDICA 

Ammoniated Tincture of Guiac 2.0-8.0 c.c. 5^-ii 

(Tinctura Guiaci Ammoniata) 

Both of these preparations are best given in milk. 



MEZEREUM 

Mezereum is obtained from the bark of Daphne mezereum, 
a European plant. Its active principles are daphnin, a 
bitter glucoside, and an acid resin. 

Action 

Applied locally: Mezereum causes redness, swelling, and 
inflammation of the skin and mucous membranes. 

Internally: It increases the secretion of saliva, sweat and 
urine. 

Poisonous Effects 

Overdoses cause nausea, vomiting, profuse diarrhoea, 
together with severe collapse, which may cause death. 



Mezereum is often applied on the skin in the form of the 
compound mustard liniment to produce redness. It is used 
internally as an alterative, in syphilis, etc. 

Preparations 

Fluidextract of Mezereum 0.6 c.c. m. x 

(Fluidextractum Mezerei) 

SASSAFRAS 

Sassafras is obtained from the bark of the Sassafras 
varifoliorum. Its active principle is a volatile oil, the oil 
of sassafras. 

ACTION 

Sassafras is said to mildly improve the nutrition of the 
body (alterative). It also increases the sweat. It is often 
given together with sarsaparilla. 



ALTERATIVES 293 

The oil of sassafras is used as a flavoring agent, and as 
a perfume. 

Preparations 

Oil of Sassafras 0.06-0.3 c.c. m. i-v 

(Oleum Sassafras) 

CALENDULA 

Calendula is obtained from the dried flowers of Calendula 
officinalis, or marigold. 

It is used to improve nutrition and to increase the sweat 
and flow of urine. 

Preparations 

Tincture of Calendula 2.0-4.0 c.c. 3^-i 

(Tinctura Calendulae) 

JAMBUL (not official) 

Jambul is obtained from the bark of Eugenia jambolana, 
an East Indian tree. 

ACTION 

Jambul contracts mucous membranes, and increases the 
flow of urine. It is said to improve diabetes. 
In India it is often used to check diarrhoea. 

STILLIGIA 

Stilligia is obtained from the Stilligia sylvatica, or queers 
delight, an English plant. 

ACTION 

Stilligia slightly improves the nutrition of the body. It 
increases all the secretions, and is said to improve the heart 
action. 

In overdoses it causes vomiting and diarrhoea. It is 
occasionally used in syphilis, chronic rheumatism, etc. 



294 MATERIA MEDICA 

Preparations 

Fluidextract of Stilligia 2.0-4.0 c.c. 5f4 

(Fluidextractum Stilligiae) 

XANTHOXYLUM 

Xanthoxylum is obtained from the bark of xanthoxylum, 
or prickly pear, an American tree. 

ACTION 

Xanthoxylum causes redness if applied locally. It is said 
to improve the nutrition of the body. It is often applied 
locally in pelvic diseases, together with tincture of capsicum. 

Preparations 
Fluidextract of Xanthoxylum 2.0-4.0 c.c. 5-J-i 

(Fluidextractum Xanthoxylii) 

LAPPA 

Lappa is obtained from the root of Arctium lappa or bur- 
dock, an American plant. 

ACTION 

Lappa improves the nutrition of the body. It is a laxa- 
tive, and it slightly increases the flow of urine and the secre- 
tion of sweat. 

Preparations 

Fluidextract of Lappa 1.0-4.0 c.c. m. xv-5i 

(Fluidextractum Lappae) 

THIOSINAMINE (not official) 

Thiosinamine is a crystalline, colorless substance made 
from the oil of mustard, by the action of an alcoholic solu- 
tion of ammonia. Chemically, it is called allyl sulpho- 
carbamide, allyl thiourea, or rhodaline. 

ACTION 

Thiosinamine softens and absorbs all kinds of scar tissue, 



ALTERATIVES 295 

swellings of the lymph glands, and swellings resulting from 
chronic inflammations, in all the organs of the body. 

Uses 

Thiosinamine is used to remove scar tissue in the eye, 
the skin, the stomach, the urethra, etc. 

Administration 

It is used locally in the form of plasters or ointments 
containing 10% of thiosinamine. 

It is usually given hypodermically however, in 10% or 
15% solutions, and occasionally it is given by mouth in 
capsules. 

Preparations 

Thiosinamine 0.03-0.1 gm. gr. ^-i| 

(Thiosinamina) 

FIBROLYSIN (not official) 

Fibrolysin is a salt made from thiosinamine. Chemically 
it is thiosinamine sodium salicylate. 

Its action is the same as that of thiosinamine but it is more 
quickly absorbed. 

It is given hypodermically, intramuscularly, or intra- 
venously. 

It usually comes in small glass vials, each containing 
2.3 c.c. of fibrolysin, which is equivalent to 0.2 gm. (gr. hi) 
of thiosinamine. 



MEDICINAL FOODS 

The following substances are used to improve the general 
health and strength of the body and to build up the tissues. 
They are not drugs, but food substances which are very 
easily digested and assimilated. Many of them are pre- 
digested, and these are of particular value in patients with 
very poor digestion. 

ACTION 

All these medicinal foods improve the health and strength, 
by helping to build up the tissues. They are often given 
together with various tonics, such as iron, arsenic, phos- 
phorus, etc. 

The medicinal foods consist largely of one or other of the 
following food principles: 

Proteids 

Carbohydrates 

Fats 

Most of the preparations consist of one or a number of 
these food principles dissolved in alcohol, or glycerin, which 
serves only to preserve them. 

PROTEID PREPARATIONS 
Solid Preparations 

CASOID DIABETIC FLOUR 

This consists of 85% of proteids obtained from milk, 
About 11% of fat, and about 3% of mineral substances, 
while the remainder is water. 

It contains no carbohydrates, or starchy foods, and is 
used in diabetes, where starchy foods should not be given. 

CIOSE 

Ciose is a dry powder made from beef which contains 
about 85% of proteids. It has a great nutritive value and 
is added to broths, soups, etc. It is often given in wine. 

296 



ALTERATIVES 297 

SOMATOSE 

Somatose is a powder which contains the proteids of meat 
in a very concentrated form. There are also preparations 
of somatose combined with iron and with milk. 

SANATOGEN 

Sanatogen is a powder consisting of sodium glycerophos- 
phate combined with casein, one of the proteids of milk. 

DRY PEPTONOIDS 

Dry peptonoids is made by digesting beef, milk and wheat. 
The proteids of these foods are digested by pancreatin, and 
the carbohydrates, with malt diastase. It is given in doses 
of 8.0-16.0 c.c. (3ii-5i) in water, milk, wine, broths, soup 
and gruels. 

Liquid Preparations 

MEAT JUICES 

Meat juices are of two kinds: 

1. Cold meat juices. 

2. Warm meat juices. 

COLD MEAT JUICE 

Cold meat juice is made by finely chopping up lean meat 
from the round of beef, then expressing the juice from these 
pieces. This contains about 6% of the meat albumins and 
is very nutritious. 

WARM MEAT JUICE 

Warm meat juice is made by chopping up lean meat from 
the round of beef, expressing the pieces, and allowing them 
to remain in water in a warm place for about half an hour. 
There are numerous meat juices on the market made by 
various firms, such as Liebig's, Valentine's, etc. 



. 



298 MATERIA MEDICA 



MEAT EXTRACTS 



The meat extracts contain very little proteids, and are 
not very nourishing. They contain mostly extractives, 
such as various salts, which make the patient feel better and 
increase the appetite. The most common beef extracts 
used are extracts made by various firms, beef teas and beef 
essences. 

LIQUID PEPTONOIDS 

Liquid peptonoids contains about 5% of proteids, and 
about 10% of carbohydrates, mainly various sugars. It is 
given in doses of 15.0-30.0 c.c. (51~i). 

ENEMOSE 

Enemose is a sterile liquid containing about 12% of pro- 
teids from beef and wheat, and about 45% of carbohydrates, 
mainly from wheat. 

It is used principally for rectal feeding. It usually comes 
in vials, the contents of one vial being dissolved in four 
parts of water and given by rectum. 

PEPTONE 

Peptone is obtained by the artificial digestion of proteid 
substances such as meat. In large doses it is injurious to 
the tissues (irritating). It is given in pastilles in doses of 
5.0 gms. It is also given in suppositories for rectal feeding, 
or it is given in enemas. 

PANOPEPTON 

Panopepton is prepared from beef and wheat by digesting 
them with pancreatin. The digested food is then dissolved in 
sherry wine. It is given in doses of 8.0-16.0 c.c. (5ii-§i). 

NUTROSE 

Nutrose is sodium caseinate, a salt obtained from casein, 
one of the proteids of milk. It is particularly valuable in 



ALTERATIVES 299 

chronic wasting diseases such as cancer, tuberculosis, and 
in pneumonia and typhoid. 

PREDIGESTED LIQUID FOOD 

Predigested liquid food is prepared by artificially digest- 
ing lean meat and milk with pepsin and hydrochloric acid. 
It contains about 10% of proteids and about 104% of 
carbohydrates. 

GELATINE 

Gelatine is an albumin like (albuminoid) substance de- 
rived from fibrous and cartilaginous tissue. It becomes 
solid when cool, and liquid when heated. It is an easily 
digested food. It helps to coagulate the blood, and is fre- 
quently used to check bleeding from the nose, the intestines, 
the kidney, etc. 

It may be applied locally to the bleeding area or it is given 
internally. 

Gelatine is frequently given hypodermically or in normal 
salt solution by means of a hypodermoclysis. The solution 
must be absolutely sterile, as tetanus occasionally results 
from unsterile gelatine because of the tetanus bacilli con- 
tained in it. 

Internally it is given in doses of 5i-ii, three or four times 
a day, or in the form of a jelly flavored to taste better. 

Preparations 

Gelatine 4.0-8.0 c.c. Si— ii 

(Gelatinum) 

Glycerinated Gelatine 
(Gelatinum Glycerinatum) 

This is gelatine impregnated with an equal amount of 
glycerin. 

MILK FOODS 

The most important medicinal foods made from milk are 
kumyss and matzoon. 



300 MATERIA MEDICA 



KUMYSS 

Kumyss or koumiss, is a fermented liquid prepared from 
mare's milk by the Tartars, who originated it. It is made 
from cow's milk in this country by the fermentation of milk 
by yeast. Liquid yeast is added to the milk, and the result- 
ing liquid is then allowed to stand for about eight to ten 
hours in a lukewarm place. 

MATZOON 

Matzoon, or kefir kumyss is made by fermenting milk 
with a kefir fungus, a fungus obtained from Caucasia in 
Russia. It is on the market under various names such as 
matzoon, zoolak, etc. There are numerous other prepara- 
tions of milk made by growing bulgaric bacilli, which form 
lactic acid in the milk. They are principally used however, 
for the effect of the bulgaric bacilli which they contain and 
they will be considered under these preparations. 

There are numerous other predigested foods which are 
very often used in weakened conditions. The most im- 
portant ones are: 

Peptonized milk gruels 
Peptonized beef tea 
Peptonized oysters 
Pancreatized milk toast, etc., etc. 



CARBOHYDRATE PREPARATIONS 

DEXTROSE OR STARCH SUGAR 

Dextrose is a sugar which is readily digested. It is used 
as a food instead of ordinary cane sugar. It is given in 
doses of 180.0 gms. (Bvi) daily. 

LEVULOSE OR FRUIT SUGAR (DIABETIN) 

Levulose is a sugar which is used to sweeten the food for 
diabetic patients who cannot take ordinary sugars. 



ALTERATIVES 301 

PREPARATIONS OF FATS 

COD LIVER OIL (OLEUM MORRHUAE) 

Cod liver oil is obtained from the livers of various species 
of codfish, especially the Gadus morrhua. 

It consists of the various fats, olein, stearin, and palmitin, 
and some fatty acids. It also contains very small quantities 
of iodine, chlorine, bromine, phosphorus, and other sub- 
stances. 

The livers were formerly left to decompose, and the 
oil which is thus formed was then gathered. By a recent 
method, the cod liver oil is obtained by forcing steam under 
pressure through the livers, and the oil is then obtained. 
This oil is pale in color and less nauseating than the oil 
formed by the old method. There are three varieties of 
cod liver oil, the dark, the light brown, and the pale yellow. 

Cod liver oil was used for many years by the fishermen 
of the North Sea as a remedy for children's diseases. It is 
now very extensively used in medicine. 

ACTION 

Cod liver oil improves the general condition of the patient 
if given for some time. It increases the appetite, and it 
makes the patient stronger, stouter and healthier. Its 
effect depends largely upon the fats which it contains. It 
differs from ordinary fats taken in the food however, by 
being more easily digested, absorbed, and assimilated by 
the body. It is digested in the intestines, and is then de- 
posited as fat in the various tissues and organs of the body, 
thereby building up the patient. 

In overdoses it causes nausea, occasionally vomiting and 
diarrhoea. 

Uses 

Cod liver oil is given principally in "run down" condi- 
tions, and in chronic wasting diseases such as tuberculosis, 
etc. It is often given together with malt or creosote. 

It is usually only given in winter because patients dislike 
it in the summer. 



302 MATERIA MEDICA 



Administration 



Cod liver oil has a very unpleasant odor and an extremely 
nauseous taste, which must be disguised when it is given. 

The unpleasant taste and odor can be disguised in the 
following ways : 

1. When given in brandy, wine, or lemon juice, in the 
same way as castor oil is given (see Castor Oil). 

2. By taking a little peppermint, and then putting the 
cod liver oil in the mouth without allowing the lips to touch 
it, so that the smell does not reach the nose. 

3. By giving the emulsions of cod liver oil which have a 
more pleasant taste. They should be fresh, however, as 
they spoil very easily. 

All preparations of cod liver oil should be given about 
three quarters of an hour to an hour after meals, the time 
when the digestion is greatest. 

In children, when it cannot be given by the mouth, it 
may be rubbed on the skin of the chest or abdomen before 
retiring, as it is readily absorbed from the skin. 

Preparations 

Cod Liver Oil 4.0-16.0 c.c. 3i-iv 

(Oleum Morrhuae) 

Emulsion of Cod Liver Oil 4.0- 8.0 c.c. 3i~ii 

(Emulsum Olei Morrhuae) 

This contains 50% of cod liver oil. 

Emulsion of Cod Liver Oil with 

Hypophosphites 4.0- 8.0 c.c. 3i~ii 

(Emulsum Olei Morrhuae cum Hypophosphitibus) 

There are numerous preparations of cod liver oil on the 
market combined with preparations of phosphorus, iron, etc. 

LECITHIN 

Lecithin is a phosphorized fat. It consists of the various 
salts of fatty acids such as oleic, stearic and palmitic acids 
combined with glycero phosphoric acid and various proteid 



ALTERATIVES 303 

substances. It is present in large quantities in nervous 
tissues. It is also present in various foods, especially in 
egg yolk and many vegetable foods. For medicinal pur- 
poses, it is made from egg yolk. 

ACTION 

Lecithin increases the nutrition of the body, though it is 
not nourishing in itself. It increases the number of red 
blood corpuscles and the haemoglobin. It is used principally 
as a tonic. 

It is given by the mouth in doses of 0.1-0.5 gm. (grs. if- 
viii) in pills, or hypodermically in doses of 1.0 c.c. (m. xv), 
or in 15% solutions in oil. 

Preparations 

Lecithin Solution 4.0- c.c. 5i 

(Containing gr. i of lecithin.) 

This is a 2% solution of lecithin in glycerin and alcohol. 
Its action and uses are the same as that of lecithin. 

Lecithol 4.0 c.c. 3i 

It is a 2% emulsion of lecithin in alcohol. It is obtained 
from the brains of hogs. 

Glycerole of Lecithin 4.0 c.c. 5i 

(Containing gr. i of lecithin.) 

Lecibrin 

This is obtained from the brains of animals and is com- 
bined with nucleoproteins. It contains 33% of lecithin. 
It comes in small gelatine coated "pepules," each containing 
grs. hi which is equivalent to about gr. ■& of phosphorus. 
Neuro Lecithin 0.1-0.5 gm. gr. i^— viii 

This is a preparation of lecithin combined with small 
amounts of fats. 



CHAPTER XII 

SECKETOEY STIMULANTS 

Secretory stimulants are drugs whose principal action is 
to increase the secretions of the secretory glands. 

PILOCARPUS OR JABORANDI 

Pilocarpus or jaborandi is obtained from the leaves 
of the Pilocarpus jaborandi, or Pilocarpus microphyllus, a 
Brazilian shrub. Its active principle is an alkaloid pilo- 
carpine. The preparations of pilocarpine, the alkaloid, are 
principally used. 

Appearance of the Patient 

About five to fifteen minutes after a dose of pilocarpine 
is given, all the secretions are increased. The patient sweats 
profusely, there is a profuse flow of saliva, of tears, and of 
mucous from the nose, mouth and bronchi. The face is 
flushed, the pupils are contracted, and the patient has diffi- 
culty in seeing distant objects. The breathing is faster, and 
the pulse is somewhat faster and weaker. Later the patient 
may have diarrhoea. 

ACTION 

Local action: Applied to the skin, pilocarpine produces no 
effects, but it is readily absorbed from such local applica- 
tions. On mucous membranes: It is readily absorbed, but 
does not affect them locally. For example, the application 
of a drop of pilocarpine solution causes general effects. 

Internal Action 

In the mouth: Pilocarpus has a bitter taste. It has an 
odor resembling hay. 
In the stomach: It increases the secretion of the mucous 

304 



SECRETORY STIMULANTS 305 

membrane, and greatly increases the peristalsis of the stom- 
ach. In large doses it often causes nausea and vomiting. 

In the intestines: Pilocarpine increases the secretion of the 
mucous membrane and the peristaltic contractions of the 
muscle wall. Frequent movements of the bowels therefore 
often result. 

Action after Absorption 

Pilocarpine is very rapidly absorbed into the blood from 
the stomach, and from all the mucous membranes upon 
which it is applied; usually in about fifteen minutes. After 
absorption it affects principally the secretory glands, the 
involuntary muscles, the pupil, the heart and respiration. 

Action on the secretory glands : This is the most important 
effect of pilocarpine. It increases the secretion of all the 
secretory glands, except the breasts, the fiver, and the 
kidneys. 

The secretion of the sweat glands is greatly increased 
(diaphoretic action). It is used principally to produce this 
effect. The great activity of the sweat glands makes the 
skin very red. About 5x-xv of sweat are secreted after 
one dose of pilocarpine, and the effect lasts for about three 
to five hours. 

There is usually a profuse secretion of saliva, of tears, of 
mucus from the nose, and from the bronchi. The secretion 
of the mucous membrane of the stomach and intestines 
is also increased. The secretion of milk, bile and urine, 
however, is not affected. 

The effect on the secretory glands is produced, by increas- 
ing the activities of the nerve endings for secretion in the 
various glands of the body. These nerve endings become 
more sensitive and they receive impulses for secretion more 
readily. 

Action on the involuntary muscles: Pilocarpine increases 
the contractions of all the involuntary muscles, by increasing 
the activity of the nerve endings in these muscles, which 
then become more sensitive and receive impulses for the 
contraction of the muscles more readily. 

The contractions of the involuntary muscles of the stom- 



306 MATERIA MEDICA 

ach and intestines (peristalsis) are increased. The contrac- 
tions of the involuntary muscles of the bronchi which pilo- 
carpine produces, make the bronchi narrower, so that the 
patient must breathe faster and deeper to inhale a sufficient 
amount of air. The contractions of the involuntary muscles 
of the bladder, often cause frequent urination accompanied 
by straining. 

The spleen and uterus are also contracted by pilocarpine. 

Action on the pupil: Pilocarpine contracts the pupil. The 
effect on the pupil is due to the increased contractions of 
the involuntary circular muscles of the iris of the eye, which 
make the pupil smaller. The contractions of the ciliary 
muscle, make the lens more convex, so that the patient 
sees only near objects, and has great difficulty in seeing 
distant ones. Pilocarpine also makes the eyeball softer, 
by causing a free circulation of fluid from the posterior to 
the anterior chamber of the eyeball. It is often used to 
produce this effect in glaucoma, a disease where the eyeball 
becomes hardened and blindness often results. 

Action on the circulation: Pilocarpine makes the heart 
beat slower and weaker. The pulse is therefore slow and 
weak. It makes the nerve endings in the heart, of the Vagus 
nerve, more sensitive; so that they receive more readily im- 
pulses to slow the heart. The pulse, however, may be some- 
what stronger and faster for a few minutes. 

Action on the respiration: The breathing becomes deeper 
and faster. This is due to the narrower bronchi which result 
from the contractions of their involuntary muscles, and the 
weakened heart action, which makes the blood accumulate 
in the lungs. The patient then has to breathe faster and 
deeper to get a sufficient amount of air in the lungs, with 
which to purify the blood. 

Effect on temperature: The profuse sweating which pilo- 
carpine produces, usually slightly lowers the temperature. 

Excretion 

Pilocarpine is excreted mainly by the kidneys and sweat. 
It begins to be eliminated in about an hour, and is entirely 
excreted in about twenty-four hours. 



SECRETORY STIMULANTS 307 

Dangers in the Use of Pilocarpine 

Pilocarpine is a very efficient drug; but its use is limited 
by some of its effects, which are often injurious to the pa- 
tient. These are: 

1. The slow and weak pulse. 

2. The profuse secretion of mucus in the bronchi fills 
up the lungs with mucus, and the contractions of the in- 
voluntary muscles of the bronchi make them narrower. The 
mucus is then expelled with difficulty, and the lungs fill 
up with fluid. This condition is known as oedema of the 
lungs. The patient is then said to ' ' drown ' ' in his own sweat. 

3. Patients often feel very weak and chilly after pilo- 
carpine. 

Poisonous Effects 

Since pilocarpine is rapidly excreted, only acute poisoning 
occurs, usually from an overdose. 

Symptoms 

1. Profuse secretion of saliva. 

2. Profuse perspiration and flow of tears. 

3. Occasionally, nausea, vomiting, abdominal pain and 
profuse diarrhoea, with watery stools. 

4. Slow, irregular, weak pulse. 

5. Rapid difficult breathing, accompanied by "rales" 
(gurgling sounds in the lungs, due to the accumulation of 
mucus). 

6. Contracted pupils. 

7. Occasionally dizziness, slight delirium, and twitchings 
of the muscles. 

The breathing finally becomes slow and shallow, the pa- 
tient complains of great weakness, and dies of failure of the 
respiration. He remains conscious to the end. 

Treatment 

1. Give atropine as an antidote. This paralyzes the 
nerve endings, which have been made more active by pilo- 
carpine and neutralizes its effects. 



308 MATERIA MEDICA 

2. Give artificial respiration if the breathing is slow and 
shallow. 

3. Give heart stimulants such as caffeine, camphor, al- 
cohol, etc. 

Uses 

1. Pilocarpine is used principally to increase the sweat, 
in cases of nephritis, when the patient secretes very little 
urine, and to remove fluid from the tissues (oedema) in 
this condition. The patient should be kept warm, wrapped 
up in blankets, to avoid unpleasant effects. 

2. It is often given as a hair tonic, in some local applica- 
tions. The hair is the secretion of the hair follicle, and the 
effect is probably due to the increased secretion of this, as 
well as of the other secretory glands, which pilocarpine 
produces. 

3. It is often given to overcome dizziness resulting from 
lessened secretion in the labyrinth of the ear. 

Preparations 

Fluidextract of Pilocarpus 0.5 -2.0 c.c. m. viii-xxx 

(Fluidextractum Pilocarpi) 

Pilocarpine 

Pilocarpine Hydrochloride 0.003-0.03 gm. gr. T V - i 

(Pilocarpinae Hydrochloridum) 

Pilocarpine Nitrate 0.003-0.03 gm. gr. ?\ - % 

(Pilocarpinae Nitras) 

Muscarine 

Muscarine is an alkaloid, which is the poisonous principle 
of various poisonous mushrooms. It produces effects ex- 
actly like those of pilocarpine. The symptoms resulting from 
eating poisonous mushrooms are the same as those of pilo- 
carpine poisoning. 

EUPATORIUM (THOROUGHWORT) 

Eupatorium is obtained from the leaves and flowers of 
the Eupatorium perfoliatum, boneset or thoroughwort. 



SECRETORY STIMULANTS 309 

It is used principally to increase the perspiration. It is 
given as an infusion, very hot; a tumblerful at a time. The 
patient should be in bed, warmly covered. 

OTHER DIAPHORETICS 

There are a number of drugs which increase the secretion 
of the secretory glands, especially the sweat glands, but they 
produce other more important effects. The most common 
ones are : 

Ipecac (especially in the form of Dover's powder) 

Antimony 

Aconite 

Veratrum Viride 

Spiritus Aetheris Nitrosi (sweet spirits of niter) 

Many of the saline diuretics, such as 

Potassium Citrate 

Solution of Ammonium Acetate 

Spirit of Mindererus 

Most of the salicylic acid preparations also increase the 
perspiration. 

Eunatrol (non-official) 1.0 gm. grs. xv 

This is sodium oleate. It is said to increase the flow of 
bile. 



DRUGS WHICH INCREASE THE ACTION OF THE 
INVOLUNTARY MUSCLES 

PHYSOSTIGMA AND ESERINE 

Physostigma is obtained from the Physostigma venenosum, 
the calabar bean, or ordeal bean. It is a large bean, growing 
on a vine, principally in Calabar, on the western coast of 
Africa. 

Its active principle is an alkaloid, eserine, or physostigmine. 
It contains two other alkaloids, calabarine, and eseridine. 

The calabar bean has been used for generations by the 
natives of the Western Coast of Africa, as a test in the trials 
by ordeal for various crimes, such as witchcraft, etc. The 
accused individual is forced to eat the bean; if he is guilty, 
he dies, otherwise he is innocent! 

Appearance of the Patient 

About fifteen minutes after giving a dose of eserine, the 
patient usually complains of cramp-like pains in the abdo- 
men and slight weakness. He often feels somewhat nau- 
seated and the bowels move very freely; the stools being 
quite fluid. There is usually a profuse secretion of saliva, 
and perspiration. 

The pulse is slow and weak, and the breathing is at first 
somewhat rapid and deep, but later it becomes slow and 
shallow. The pupils are contracted, and the patient is 
unable to see distant objects clearly, and usually complains 
of weakness. 

ACTION 

The action of physostigma is due to the eserine which it 
contains. This is the preparation which is commonly used. 
The effects of eserine, are quite similar to those of pilocar- 
pine. 

Local action: Applied to the skin, or mucous membranes, 
it produces no effects; but the drug is readily absorbed from 
mucous membranes. 

310 



SECRETORY STIMULANTS 311 

Internal Action 

In the mouth : No effects are produced. 

In the stomach and intestines: It increases the secretions 
of the mucous membranes, and it increases the peristalsis 
very markedly, much more so than pilocarpine does. Cramp- 
like abdominal pains with frequent fluid stools are often 
produced by eserine. 

Action after Absorption 

Eserine is very rapidly absorbed into the blood from the 
stomach, in about fifteen minutes to a half hour. After 
absorption it affects principally the involuntary muscles, 
the pupil, the secretory glands, the circulation and the res- 
piration. 

Action on the involuntary muscles: Eserine increases the 
contractions of all the involuntary muscles, by increasing 
the activity of the nerve endings in the muscle wall. These 
nerve endings then become more sensitive, and receive 
impulses for contraction of the muscles more readily. 

The muscles of the intestines are particularly affected, the 
peristalsis is very much increased, and frequent fluid move- 
ments of the bowels result. The contractions of the muscles 
of the ureter, bladder and uterus, are also increased. 

Action on the pupils: It contracts the pupil if applied 
locally to the conjunctiva, or when given internally. It 
makes the nerve endings of the circular muscles of the iris 
more sensitive, so that impulses for their contractions are 
more readily received. 

Eserine also contracts the ciliary muscle of the eye, which 
holds the lens in place. The contraction of this muscle 
makes the lens more convex, so that the patient is unable 
to see distant objects clearly. It also causes a free circula- 
tion of fluids from the posterior to the anterior chamber of 
the eye, thereby making the eyeball softer. Eserine is often 
used to produce this effect in glaucoma, a disease where the 
eyeball becomes hardened, and which often results in blind- 
ness. 

Action on the secretory glands: Eserine increases the 



312 MATERIA MEDICA 

secretion of all the secretory glands, by making their nerve 
endings more sensitive to receive impulses for secretion. 

The secretion of saliva, mucus from the nose and bronchi; 
the tears, perspiration, the pancreatic, the stomach and 
intestinal secretions are all increased. 

Action on the circulation: On the heart, eserine makes the 
heart beat slower, by making the nerve endings of the Vagus 
nerves in the heart, more sensitive to receive impulses which 
slow the heart. 

On the blood vessels: The contractions of the involun- 
tary muscle fibers in the walls of the blood vessels make 
them narrower. The blood pressure is thus raised; usually, 
however, this effect is not very marked. The pulse of eserine 
is therefore slow and strong. 

Action on the respiration: Eserine makes the breathing 
slow and shallow, by lessening the activity of the respiratory 
center in the medulla, so that fewer impulses for breathing 
are sent out. Very often the breathing may be somewhat 
rapid at first. 

Action on the spinal cord: It lessens the reflex action of 
the medulla on spinal cord. 

Excretion 

Eserine is very rapidly eliminated from the body by the 
urine and also by all the secretions. It begins to be excreted 
in a few minutes, and is entirely excreted in a few hours. 

Poisonous Effects 

Since eserine is very rapidly excreted, only acute poisoning 
occurs; usually from an overdose of the drug, given hypoder- 
mically or when dropped into the eye. 

Symptoms 

1. Abdominal pain. 

2. Nausea and vomiting. 

3. Diarrhoea, with frequent watery stools. 

4. Excessive flow of saliva and perspiration. 

5. Slow, shallow, difficult breathing. 

6. Slow, irregular, weak pulse. 



SECRETORY STIMULANTS 313 

7. Contracted pupils. 

8. Twitchings of the muscles, great muscular weakness 
and dizziness. 

9. Collapse. 

Treatment 

1. Wash out the stomach. 

2. Keep the patient warm. 

3. Give artificial respiration. 

4. Give atropine hypodermically. This is the antidote; 
as it paralyzes the overacting nerve endings, and increases 
the breathing. 

5. Treat the collapse, with heart stimulants; such as 
alcohol, camphor, etc. 

Uses 

Eserine is principally used: 

1. To soften the eyeball, in glaucoma and to contract the 
pupil. 

2. To increase the peristalsis, to cause frequent move- 
ments of the bowels, and to expel gas. It is frequently 
used to produce this effect on patients that have just been 
operated upon, and who have difficulty in passing gas; 
especially after gynecological operations. It must never 
be given when the operation has been performed upon the 
stomach or intestines. 

3. It is occasionally used in chronic constipation. 

Preparations 

Physostigma 
Extract of Physostigma 0.015-0.06 gm. gr. i-i 

(Extractum Physostigmatis) 

Tincture of Physostigma 1.0-3.0c.c. m. xv-xlv 

(Tinctura Physostigmatis) 

Eserine 

Eserine Salicylate 0.001-0.003 gm. gr. T^-ih 

(Physostigminae Salicylas) 

Eserine Sulphate 0.001-0.003 gm. gr. v \ - & 

(Physostigminae Sulphas) 



CHAPTER XIII 

UTERINE STIMULANTS 

The following group of drugs increase the contractions of 
the uterus. They are divided into two classes. 

Oxytocics 
Emmenagogues 

Oxytocics are drugs which are used to contract the uterus, 
and expel its contents. 

Emmenagogues are drugs which are used to increase, or 
to cause menstruation, when its absence is due to other 
causes than pregnancy. 

When these drugs are used to bring about menstruation 
in pregnancy, they may be injurious; because they must be 
given in poisonous doses to produce this effect. Serious and 
even dangerous symptoms may then result, such as excessive 
bleeding, sepsis, etc. 

OXYTOCICS 

ERGOT (ERGOTA) 

Ergot is a black parasitic fungus, which grows on the rye 
plant Secale cereale, the fungus taking the place of the 
rye grain. It is a very complex substance, and varies in its 
activity. It is said to consist of three active substances, 
cornutine, an alkaloid; sphacelotoxin, a resinous substance 
which resembles the sapotoxins, or soapy glucosides, in its 
effects; and ergotinic acid. 

Each one of these substances produces some of the effects 
of ergot; but none of them can really be said to be the active 
principle. 

It has recently been claimed that a newly discovered 

314 



UTERINE STIMULANTS 315 

alkaloid in ergot, ergotoxine, is the active principle. It 
causes the same effects produced by ergot. 

Appearance of the Patient 

Ergot is usually given to patients for bleeding from the 
uterus, or immediately after the birth of a child. 

Within fifteen minutes to a half hour after a dose of a 
preparation of ergot is given, the patient usually complains 
of violent cramp-like pains in the lower part of the abdomen, 
particularly in the region of the uterus. If there has been 
bleeding from the uterus, this gradually becomes diminished. 

The patient feels nauseated when it is given, and frequent 
movements of the bowels may result soon after. 

It usually makes the pulse slow and strong. 

ACTION 

Local action: Ergot produces no effect on the skin. If it 
is given hypodermically, it is quite injurious to the tissues, 
and is apt to cause an abscess at the site of injection. On 
mucous membranes: It causes redness and swelling, with 
profuse secretion of mucus. 

Internal Action 

In the mouth: Ergot has a very unpleasant taste; it often 
increases the flow of saliva because of the redness of the 
mucous membrane of the mouth which it causes. 

In the stomach: It increases the secretion of the mucous 
membrane, and the contractions of its muscle wall. It 
therefore often causes nausea and vomiting. 

In the intestines: The secretions of the mucous membrane, 
and the contractions of the muscle wall of the intestines, 
are both greatly increased by ergot. This often causes fre- 
quent movements of the bowels, accompanied by griping 
pains. 

Action after Absorption 

Ergot is rapidly absorbed into the blood through the 
mucous membrane of the stomach. Its effects usually ap- 
pear within a half hour. After absorption it affects prin- 



316 MATERIA MEDICA 

cipally the uterus, the involuntary muscles and the circula- 
tion. 

Action on the uterus: This is the most important action 
of ergot. Ergot increases the contractions of the uterus. It 
produces wavelike contractions of the uterine muscles, which 
expel the contents of the uterus. It does not always start 
uterine contractions, but it always increases them when 
they are once started. By contracting the uterus, ergot 
closes its blood vessels and stops uterine bleeding. 

Action on the involuntary muscles: It increases the con- 
traction of all the involuntary muscles, especially the small 
muscle fibers in the walls of the blood vessels, and the mus- 
cles of the stomach and intestines. 

Action on the circulation: On the heart, ergot makes the 
heart beat slower by increasing the impulses which slow the 
heart, sent out from the Vagus or inhibitory center in the 
medulla of the brain. 

On the blood vessels: The blood vessels are made nar- 
rower, by the contractions of the small muscle fibers in 
their walls, and by the greater number of impulses reaching 
these fibers from the vaso-constrictor center in the medulla. 
The narrow blood vessels increase the blood pressure, and 
offer a greater resistance to the contractions of the heart, 
which then contracts stronger. 

The pulse of ergot is therefore slow and strong. 

Action on secretions: The secretion of sweat and milk 
is lessened. 

Excretion 

The exact mode of excretion of ergot is unknown, but it is 
probably eliminated by the bowels and kidneys. 

Cornutine 

The slow pulse, nausea, vomiting and diarrhoea are caused 
by the cornutin; which increases the activity of various 
centers in the medulla oblongata, especially the Vagus center 
and the vaso-constrictor center. 

Sphacelotoxin 
The uterine contractions, and the contractions of the 



UTERINE STIMULANTS 317 

muscle fibers in the walls of the blood vessels, are produced 
by sphacelotoxin, which increases the contractions of all 
the involuntary muscles. 

Poisonous Effects 

There are two forms of ergot poisoning, acute poisoning 
and chronic poisoning. 

Acute Ergot Poisoning 

Acute ergot poisoning is very rare and usually occurs from 
large doses of ergot, taken to produce abortion. 

Symptoms 

1. Cramp-like abdominal pain. 

2. Vomiting. 

3. Diarrhoea. 

4. Unquenchable thirst. 

5. Bleeding from the uterus. 

6. Abortion. 

7. Jaundice. 

8. Haemorrhages into the skin. 

9. Tingling and itching of the skin. 

10. Collapse (rapid, weak pulse, cold skin, slow and shal- 
low breathing, etc.). 

There may be convulsions before death. 

Treatment 

1. Wash out the stomach. 

2. Treat the collapse with heart stimulants; such as 
caffeine, strychnine, etc. 

Chronic Ergot Poisoning 

Chronic ergot poisoning results from eating rye bread, 
made from rye which has been infected with the ergot 
fungus. This is more apt to occur in the rye growing during 
wet seasons. 

Ergot poisoning is very common in Russia and other 
northern countries, where a good deal of rye bread is eaten. 



318 MATERIA MEDICA 

In the mediaeval ages plagues of ergot poisoning were quite 
common. 
There are two forms of chronic ergot poisoning. 

1. The Gangrenous form 

2. The Spasmodic form 

In some epidemics the gangrenous form, and in others the 
spasmodic form predominates. 

Gangrenous Form 

This is due principally to sphacelotoxin, which contracts 
the blood vessels so much, that the circulation of various 
parts of the body is cut off, and the part affected then dies, 
or becomes gangrenous. 

Symptoms 

The limbs are first affected. The fingers and toes become 
cold, they lose their sensation, and become blue in color. 
Soon they become hard and shriveled up and fall off; without 
any pain. Sometimes the gangrene spreads up over the 
extremities, and the forearm or leg may become gangrenous 
and fall off. Sometimes the internal organs become gan- 
grenous in this way. Ulcers in the stomach and intestines 
then frequently occur, because the circulation of various 
areas of these organs is cut off. Ulcers of the cornea of the 
eye often result because its circulation is cut off. 

Nervous or Spasmodic Form 

This is due to cornutine, which causes increased activity 
of the brain. The brain soon becomes exhausted, however, 
so that symptoms of lessened activity, or depression, result. 

Symptoms 

1. Weakness. 

2. Drowsiness. 

3. Headache. 

4. Dizziness. 

5. Itching, and a feeling as if something were creeping 
over the limbs (formication). 



UTERINE STIMULANTS 319 

6. Painful cramps in the limbs. 

7. Clonic convulsions, followed by epileptiform convul- 
sions. 

The mind remains clear after the attacks, but often the 
patient becomes insane. 

The treatment depends upon the various symptoms which 
occur. 

Uses 

Ergot is used to contract the uterus, to prevent or check 
uterine bleeding. It should always be given when the uterus 
is empty. 

In labor cases it should always be given after the third 
stage of labor, that is, after the birth of the placenta. If 
ergot is given before the placenta is entirely expelled, the 
contractions of the uterus may cause pieces of the placenta 
to remain in the uterus, which may then become infected 
and cause sepsis. 

Ergot is frequently given to check bleeding from the 
lungs, from an ulcer of the stomach, from an ulcer of the 
intestines in typhoid fever, etc. The bleeding is checked by 
the contractions of the bleeding vessels. 

Administration 

Ergot has a very unpleasant taste which should always 
be disguised. It is best given after meals. 

When given hypodermically, it should be injected deep 
into the muscles, and the part should then be massaged very 
thoroughly. 

Preparations 

Fluidextract of Ergot 4.0-8.0 c.c. 3 i— ii 

(Fluidextractum Ergotae) 

Wine of Ergot 10.0-20.0 c.c. 5iiJ-v 

(Vinum Ergotae) 

This contains about 20% of ergot. 

Ergot preparations change very readily, if kept for any 
length of time. They may then be entirely inactive. 

There are a number of preparations of ergot on the market 



320 MATERIA MEDICA 

which are suitable for hypodermic use. There are other 

preparations which are not so nauseating and are more 

reliable than the usual preparations. Most of them are 
not official. 

New and Non-official Preparations 

Purified Extract of Ergot: 0.2-0.5 gm. grs. iii-viii 

Extractum Ergotae Purificatum 
(Bonjean's Ergotin) 

This is a purified extract of ergot about ten times as 
strong as ergot itself. It is often given hypodermically. 

Ergotole 0.3 2.0 c.c. m. v-xxx 

This is an excellent preparation made from specially cul- 
tivated Spanish ergot. It is about 2\ times as strong as 
the fluidextract. It is suitable for hypodermic use. 

Ernutin 2.0-4.0 c.c. m. xxx-5 i 

This has a pleasant taste, and is a reliable preparation of 
ergot. It is also given hypodermically in doses of 0.3-0.6 c.c. 
(m. v-x). 

Ergotoxin 0.0006-0.0012 gm. gr. 1 f T - '-fa 

This is said to be the active principle of ergot and is given 
hypodermically. 

Ergotonine Citrate 0.0006-0.0012 gm. gr. X U- A 

(Ergotoninae Citras) 

This is an alkaloid, which is changed in the body to ergo- 
toxine. 

_ | hypodermically 0.6-2.0 c.c. m. x-xxx 

( by mouth 0.6-4.0 c.c. m.x~5i 

(Liquid Extractum Ergotae) 

This is a preparation of ergot which has been tested and 
found to be reliable. 

HYDRASTIS (GOLDEN SEAL) 

Hydrastis is obtained from the roots and underground 
stems of Hydrastis canadensis, golden seal or yellow root. It 



UTERINE STIMULANTS 321 

is a small shrub growing in the United States. Its active 
principles are the alkaloids, hydrastine and berberine. 

Appearance of the Patient 

After giving hydrastis, or any of its alkaloids, the patient 
usually has a better appetite, and the bowels move more 
freely. If there has been bleeding from the uterus, this is 
gradually checked. The pulse is slow and strong. 

ACTION 

Local action: On the skin, hydrastis has no effect. Ap- 
plied to mucous membranes: It increases their secretions. 

Internal Action 

In the mouth: It has a bitter taste and increases the flow 
of saliva. 

In the stomach: It increases the appetite, and aids diges- 
tion by increasing the secretion of gastric juice, and the 
peristalsis of the muscle wall of the stomach. 

In the intestines : It increases the secretion and peristalsis, 
causing frequent movements of the bowels. 

Action after Absorption 

Hydrastis is slowly absorbed into the blood, mainly 
through the intestinal mucous membrane. After absorption, 
it affects principally the circulation, the involuntary muscles, 
especially the muscle fibers in the walls of the blood vessels, 
and the uterus. 

Action on the circulation : On the heart, hydrastis makes the 
heart beat slower, by increasing the impulses which slow the 
heart, that are sent out from the medulla of the brain. 

On the blood vessels: It makes the blood vessels nar- 
rower by contracting the muscle fibers in their walls. This 
increases the blood pressure and helps to make the heart 
beat stronger. 

The total effect on the circulation is to make the heart 



322 MATERIA MEDICA 

beat slower and stronger, which causes a slow and strong 
pulse. 

Action on the uterus: Hydrastis contracts the uterus. By 
this effect, and the contractions of the uterine blood vessels 
which it causes, it checks bleeding from the uterus. 

Action on the involuntary muscles: It contracts all the 
involuntary muscles, such as those of the intestines, of the 
iris, as well as those of the blood vessels. 

Hydrastis is said to increase the secretion of bile. 

Excretion 

Hydrastis and its alkaloids are mainly eliminated from 
the body by the kidneys. It is excreted very slowly, much 
slower than it is absorbed, so that cumulative symptoms 
often result from continual administration. 

Hydrastine 

The slow, strong pulse, the contractions of the blood ves- 
sels, the contractions of the uterus, and other involuntary 
muscles, are due to the action of hydrastine. 

Berberine 

The increased appetite, the increased secretions of the 
stomach and intestines are due to berberine; which is a 
simple bitter. This alkaloid is often found in many other 
plants used as simple bitters. 

Poisonous Effects 

Poisoning from hydrastis or from its alkaloids is extremely 
rare. In the few cases that have occurred the symptoms 
were, 

1. Vomiting. 

2. Headache. 

3. Dizziness. 

4. Difficult breathing. 

5. Slow, weak, irregular pulse. 

6. Convulsions. 

7. Collapse, and death from failure of breathing. 



UTERINE STIMULANTS 323 

Uses 

Hydrastis is used : 

1. As a bitter, to increase the appetite and aid digestion 
by increasing the secretion of the gastric juice. 

2. To check uterine bleeding. 

3. For constipation, to make the stools more fluid in 
character. 

Preparations 

Fluidextract of Hydrastis 1.0-4.0 c.c. m. xv-3i 

(Fluidextractum Hydrastis) 

Tincture of Hydrastis 1.0-4.0 c.c. m. xv-5i 

(Tinctura Hydrastis) 

Glycerite of Hydrastis 1.0-4.0 c.c. m. xv-3i 

(Glyceritum Hydrastis) 

This is used principally to improve inflammations of the 
mucous membrane. 

Hydrastine is rarely used, but an artificial alkaloid made 
from it, hydrastinine, is very frequently used. 

HYDRASTININE 

Hydrastinine is an artificial alkaloid made by oxidizing 
hydrastine. 

It produces the same effect as hydrastis, but it is more 
efficient and its effects are more lasting. 

ACTION 

It contracts the uterus and the blood vessels very mark- 
edly. The blood pressure is very much increased after 
hydrastinine. It is used to check uterine bleeding. 

Preparations 

Hydrastinine Hydrochloride 0.03-0.1 gm. gr. ^ — li 
(Hydrastininae Hydrochloridum) 

It is given hypodermically in solution, and by the mouth 
in pills or tablets. 



324 MATERIA MEDICA 

STYPTICIN (COTARNINE HYDROCHLORIDE) 

(not official) 

Cotarnine hydrochloride, or stypticin, is an artificial 
alkaloid, made by oxidizing narcotine, one of the alkaloids 
of opium. 

ACTION 

It contracts the blood vessels, and the uterus. 

It is principally used to check bleeding from the uterus. 
It is also used to check bleeding from other parts of the 
body, such as the lungs, the stomach, or the intestines, by 
contracting the blood vessels of these organs. Gauze soaked 
in cotarnine is very frequently used by dentists to check 
bleeding. 

Preparations 

Cotarnine Hydrochloride (Stypticin) 0.015-0.1 gm. grs. ^ — ii 
(Cotarninae Hydrochloridum) 

It is given hypodermically in solution, or by the mouth in 
pills or tablets. 

Cotarnine Phthalate (Styptol) 
(Cotarninae Phthalas) 

Hypodermically 0.2 gm. (grs. iii) dissolved in 2.0 c.c. (m. xxx) of 
water. 

By mouth, 3 to 5 tablets a day. Each tablet contains gr. £ 
of the drug. 

PITUITARY EXTRACTS (not official) 

Pituitary extracts or pituitrin, is an extract of a small 
gland, situated at the base of the brain. It causes marked 
contractions of the uterus in about half an hour after it is 
given. The contractions usually last for several hours. 

It is used to check bleeding from the uterus and to cause 
uterine contractions after labor. 

These substances produce other more important effects, 
which will be considered later. (See page 626.) 



UTERINE STIMULANTS 325 

Administration 

Pituitary Extract, or pituitrin, should be given hypoder- 
mically, as these substances are apt to be digested by the 
stomach. 

Preparations 

Pituitrin 1.0 c.c. m. xv 

In small glass vials, for hypodermic use. 
Pituitary Extract 1.0 c.c. m. xv 

In small glass vials. 

TYRAMINE 0.02 gm. gr. 1| 

This is a chemical substance, which is used to contract 
the uterus and increase the blood pressure. 

GOSSYPIUM (COTTON ROOT BARK) 

Gossypium cortex is the dried bark of the ordinary cotton plant, 
Gossypium herbaceum. 

It has been used by the southern negroes to produce abor- 
tion. It is occasionally used as a substitute for ergot to 
contract the uterus and to check uterine bleeding. 

Preparations 
Gossypii Cortex 2.0 gms. grs. xxx 

QUININE 

Quinine is used to increase uterine contractions. It has 
other more important actions however, under which it will 
be described. 

EMMENAGOGUES 

Emmenagogues are drugs which increase menstruation. 

SABINA (SAVTNE) 

Savine is obtained from the dried top of the Juniperus 
sabina, an evergreen shrub of Southern Europe, and eastern 



326 MATERIA MEDICA 

countries. Its active principle is a volatile oil, resembling 
turpentine. 

ACTION 

Local action: Applied to the skin, or mucous membrane, 
it causes pain, redness and swelling, and on mucous mem- 
branes increased secretions. 

Internal Action 

In the mouth : It causes redness and secretion of saliva. 

In the stomach and intestines: It increases the secretion 
of the mucous membrane and the peristalsis of the muscle 
walls. 

Nausea, vomiting and diarrhoea often occur as a result 
of this action. 

Action after Absorption 

Savine is rapidly absorbed from the stomach. After ab- 
sorption it affects the heart, the uterus and the kidneys. 

Action on the heart: It makes the heart beat stronger 
and faster, causing a rapid, strong pulse. 

Action on the uterus: Savine increases the contractions 
of the uterus, and the menstrual flow. It is often taken to 
produce abortion; but it is a dangerous drug, and may 
cause severe poisonous symptoms. 

Action on the kidney: Savine increases the flow of urine. 

Excretion 
It is eliminated from the body mainly in the urine. 

Poisonous Effects 

Acute savine poisoning usually results from large doses of 
savine taken to produce abortion. 

Symptoms 

1. Violent abdominal pain. 

2. Nausea and vomiting. 

3. Profuse diarrhoea, with bloody stools. 

4. Abortion. 



UTERINE STIMULANTS 327 

5. Scanty urine. 

6. Difficult breathing. 

7. Twitchings of the muscles, and convulsions. 

8. Collapse (rapid, thready pulse; slow, shallow breath- 
ing; cold, moist skin, etc.). 

Treatment 

1. Wash out the stomach. 

2. Treat the collapse with heart stimulants. 

Uses 

Savine is used to increase menstruation, when its absence 
is not due to pregnancy. 

Preparations 

Fluidextract of Savine 0.3-1.0 c.c. m. v-xv 

(Fluidextractum Sabinae) 

Oil of Savine 0.3-0.6 c.c. m. v-x 

(Oleum Sabinae) 

RUE (RUTA) 

Rue is obtained from the leaves of the Ruta graveolens, 
or garden rue. Its active principle is a volatile oil. 

ACTION 

Its action is similar to that of savine; but it is not as 
dangerous. It is used to increase menstruation, when its 
absence is not due to pregnancy. It is occasionally taken 
to produce abortion, and it then often causes poisonous 
symptoms. 

Preparations 

Oil of Rue 0.06-0.2 c.c. m. i-iii 

(Oleum Rutae) 

TANSY (TANACETUM) (not official) 

Tanacetum or tansy is obtained from the leaves and tops 
of the ordinary garden tansy, Tanacetum vulgare. Its active 
principle is a volatile oil. 



328 MATERIA MEDICA 

ACTION 

Local action: Applied to the skin or mucous membranes, 
it causes redness and swelling with profuse secretion from 
the mucous membranes. 

Internal Action 

In the stomach and intestines: It causes redness, swelling 
and increased secretion (irritation) with increased peristalsis. 
Nausea, vomiting and diarrhoea often result from this 
action. 

Action after Absorption 

Tansy is absorbed into the blood from the stomach. After 
absorption it affects principally the uterus and the kidney. 

Action on the uterus: Tansy increases the contractions 
of the uterus and increases the menstrual flow. 

Action on the kidney : It increases the flow of urine. 

Excretion 
Tansy is eliminated from the body mainly by the kidneys. 

Poisonous Effects 

Poisonous symptoms usually result from large doses of 
tansy or tansy tea taken to produce abortion. 

Symptoms 

1. Violent abdominal pain. 

2. Vomiting and diarrhoea with bloody stools. 

3. Abortion. 

4. Scanty bloody urine. 

5. Convulsions. 

6. Unconsciousness. 

7. Collapse. 

Death usually results from paralysis of the respiration. 

Treatment 
1. Wash out the stomach. 



UTERINE STIMULANTS 329 

2. Treat the collapse with heart stimulants, such as 
caffeine, atropine, strychnine, etc. 

3. For the convulsions give inhalations of chloroform. 

Preparations 

Oil of Tansy 0.06 c.c. m. i 

(Oleum Tanaceti) 

Infusion of Tansy 
(Infusum Tanaceti) 

This infusion contains 0.6-1.6 gms. (grs. x-xxv) of tansy. 



OIL OF PENNYROYAL (OLEUM HEDEOMAE) 

The oil of pennyroyal is a volatile oil obtained from the 
leaves and tops of Hedeoma pulegioides, or the pennyroyal 
plant. 

It is used to expel gas from the intestine and to increase 
the menstrual flow. It is not a very active drug, but it is 
commonly used as a household remedy. 

Preparations 

Oil of Pennyroyal 0.0&-O.3 c.c. m. i-v 

(Oleum Hedeomae) 

APIOL 

Apiol is an oily liquid (a stearoptene), obtained from the 
root of ordinary garden parsley or Apium petrosinellum. It 
resembles camphor and is often called parsley camphor. 
Its active principle is said to be a substance called apioline. 

Apiol is used to increase the menstrual flow, especially 
when the scanty menstruation is due to anaemia and when 
the menstruation is painful. 

Preparations 
Apiol 0.2-0.6 gm. grs. iii-x 

Apioline 0.2-0.5 gm. grs. iii-viii 

Apiol is given in capsules; most of which are imported 



330 MATERIA MEDICA 

from France. Each capsule contains 0.25 gm. (grs. iv). 
There are a number of preparations of apiol combined with 
ergot and other substances. 

Other substances used as emmenagogues are cantharides, 
guiac, etc. 



CHAPTER XIV 



DIURETICS 



Diuretics are drugs which increase the flow of urine. 

They may be classified in two groups; indirect and direct 
diuretics. 

Indirect diuretics are drugs which increase the flow of 
urine, by improving the circulation of the kidneys. In this 
way the kidneys are supplied with more blood from which 
to secrete urine. 

Direct diuretics are drugs which increase the flow of 
urine by directly increasing the activity of the kidney 
cells. 

Diuretics may also be classified according to their chemical 
nature; such as saline diuretics, alkaline diuretics, vegetable 
diuretics, etc. 

INDIRECT DIURETICS 

The following drugs increase the flow of urine by improving 
the circulation of the kidneys. They make the heart beat 
stronger so that the blood is kept circulating more freely. 
More blood is therefore brought to the kidney more fre- 
quently, and the kidneys are then better able to manufac- 
ture urine. Thus the secretion of urine is increased. 

The most important indirect diuretics are: 

Digitalis 
Strophantis 
Squills 
Apocynum 

These drugs are used as heart stimulants, and their effects 
are described under that group. 

331 



332 MATERIA MEDICA 

DIRECT DIURETICS 
THEOBROMA (THEOBROMINE) AND DIURETIN 

Theobromine is a white powder, an alkaloid, obtained 
from the seeds of the Theobroma cacao, the chocolate tree 
of South America. It is very closely related, chemically, 
to caffeine. Its action is similar to that of caffeine. 

ACTION 

Local action: Theobromine has no effect when applied 
either to the skin or on mucous membranes. 

Internal Action 

In the mouth: It has a somewhat bitter taste. 

In the stomach and intestines: It increases the secretions 
and peristalsis; often causing nausea, vomiting and frequent 
movements of the bowels. 

Action after Absorption 

Theobromine and its salts are rapidly absorbed from the 
stomach; usually in about a half to one hour. After absorp- 
tion, it affects principally the heart, the muscles and the 
kidney. 

Action on the heart: It makes the heart beat stronger and 
faster. It also contracts the blood vessels. The pulse is 
therefore stronger and faster. 

Action on the muscles: Theobromine increases the con- 
tractions of all the muscles. 

Action on the kidneys: Theobromine and its salts are 
excellent diuretics. They increase the flow of urine, by di- 
rectly increasing the activity of the kidney cells. In this 
way, they remove fluid from the tissues; relieving oedema 
of the extremities, and fluid in the abdomen (ascites). 

Excretion 

Theobromine and its salts are rapidly eliminated from 
the body mainly by the kidneys; usually in a few hours. 



DIURETICS 333 

Poisonous Effects 

Since theobromine is rapidly excreted, it very rarely pro- 
duces poisonous effects. When poisonous symptoms do 
occur, they are the same as those produced by caffeine. 

Administration 

Since theobromine and its salts are rapidly eliminated, 
they are best given in small doses, frequently repeated 
(about every two hours), when a continual effect is desired. 

Preparations 
All these preparations are not official. 

Theobromine 0.3-1.0 gm. grs. v-xv 

(Theobromina) 

This preparation is apt to upset the stomach. 

Theobromine Sodium Salicylate 0.3-1.0 gm. grs. v-xv 
(Theobrominae Sodii Salicylas) 
(Diuretin) 

This preparation is very frequently given as a diuretic, 
because it is more readily dissolved than the others. 

Theobromine Sodium Acetate 0.3-1.0 gm. grs. v-xv 

(Theobrominae Sodii Acetas) 
(Agurin) 

Theobromine and Lithium Benzoate 0.3-1.0 gm. grs. v-xv 
(Theobrominae et Lithii Benzoas) 
(Urophen B) 

Theobromine and Lithium Salicy- 
late 0.3-1.0 gm. grs. v-xv 
(Theobrominae et Lithii Salicylas) 
(Urophen S) 

CAFFEINE 

Caffeine is an excellent diuretic. It increases the flow 
of urine by directly increasing the activity of the kidney 
cells. 



334 MATERIA MEDICA 



THEOPHYLLIN 



Theophyllin is the active principle of tea leaves. Its ac- 
tion is similar to that of caffeine. It is occasionally used 
to increase the flow of urine. 

Preparations 

Theophyllin Sodium Acetate 0.2-0.3 gm. grs. iii-v 
(Theophyllinae Sodii Acetas) 

THEOCIN 

Theocin is artificial theophyllin. It is used to increase 
the flow of urine. 

Preparations 

Theocin 0.2-0.3 gm. grs. iii-v 

(Theocinae) 

VEGETABLE DIURETICS 

The following drugs are obtained from various plants 
and act as diuretics. 

SCOPARIUS (BROOM TOPS) 

Scoparius is obtained from the dried tops of the Cytisus 
scoparius, or common broom plant which grows in Europe 
and the United States. Its active principles are, a fluid 
alkaloid sparteine, and a neutral substance scoparin. Its 
diuretic action is due to the scoparin. 

ACTION 

The principal action of scoparius is to increase the flow 
of urine, but its effect is not very marked, however. 

Preparations 

Scoparius is given in the form of a decoction, made by 
boiling about 15.0 gms. (5i) of broom tops in water to make 
up 250.0 c.c. (i pint). Of this, about 30.0 gms. (3i) is given 
every 2 or 3 hours. 



DIURETICS 335 

Sparteine, the alkaloid of scoparius, lessens the contrac- 
tions of involuntary muscles and weakens the heart action. 
It will be described more fully under these more important 
effects. 

TARAXACUM 

Taraxacum is obtained from the root of the Taraxacum 
officinale, or ordinary dandelion. Its active principles are 
two neutral bitter substances taraxacin and taraxacein. 

ACTION 

Taraxacum acts as a simple bitter and laxative. It also 
increases the flow of urine. 

Preparations 

Extract of Taraxacum 0.3-1.0 gm. grs. v-xv 

(Extractum Taraxaci) 

Fluidextract of Taraxacum 4.0-8.0 c.c. 3i-ii 

(Fluidextractum Taraxaci) 

JUNIPER 

Juniper is obtained from the unripe, full sized berries of 
the Juniper communis, or juniper plant. Its active principle 
is a volatile oil, the oil of juniper, which is obtained by 
distilling the berries. 

ACTION 

Local action: Juniper produces slight redness of the skin 
and mucous membranes if applied locally. 

Internal Action 

Taken internally : It increases the secretion of the stomach 
and intestines. It thereby increases the appetite and aids 
digestion. Its principal effect, however, is to increase the 
flow of urine. 

Poisonous Effects 

Overdoses of juniper usually cause painful urination with 
bloody urine. 



336 MATERIA MEDICA 

Administration 

Juniper is rarely given alone. It is usually combined 
with cream of tartar or other alkaline diuretics. 

Preparations 

Oil of Juniper 0.3-1.0 c.c. m. v-xv 

(Oleum Juniperi) 

Spirits of Juniper 2.0-4.0 c.c. m. xxx-5i 

(Spiritus Juniperi) 

The most commonly used preparation, however, is the 
infusion of juniper berries. It is made by boiling an ounce 
of the berries in a pint of water, and is given in doses of 
2.0 to 4.0 c.c. (3 i-ii). 

TURPENTINE (TEREBINTHINA) 

There are two kinds of turpentines: turpentine or white 
turpentine, and Canada turpentine or Canada balsam. 

Turpentine, or white turpentine, terebinthina, is a thick 
resinous substance, or solid oleoresin obtained from the 
sap of the Pinus palustris, and other species of pine trees. 

Canada turpentine, terebenthina canadensis, or Canada 
balsam, or balsam of fir, is a liquid oleoresin obtained from 
the Abies balsamea, the American silver fir, or balm of gilead 
tree, which grows in the northern parts of the United States. 
This form of turpentine is seldom used. The turpentines 
contain a volatile oil, oil of turpentine, or spirit of turpentine, 
which causes their effects. 

ACTION 

Local action: Turpentine or the spirit of turpentine, red- 
dens the skin. If it is kept on the skin for any length 
of time, it causes blisters. 

Internal Action 

When taken internally, the oil of turpentine produces the 
following effects. 

In the stomach: It checks the formation, and hastens the 



DIURETICS 337 

expulsion of gas. Part of it is absorbed into the blood from 
the stomach. 

In the intestines: It acts as an antiseptic, checking the 
growth of bacteria. It expels gas and increases peristalsis. 
It is said to expel worms. 

On the kidneys: Turpentine and the oil of turpentine 
increases the flow of urine. This effect is produced by the 
turpentine after it is absorbed into the blood. 

Turpentine is said to make the pulse somewhat stronger 
and faster. 

Excretion 

Turpentine is eliminated from the body by the lungs, 
where it increases the cough and expectoration, and acts 
as an antiseptic. It is also excreted by the kidneys and 
gives the urine a violet color. 

Poisonous Effects 

Overdoses of turpentine cause: 

1. Unconsciousness. 

2. Scanty, often bloody urine. 

3. Rapid, feeble pulse. 

4. Occasionally vomiting, and diarrhoea, with painful 
stools. 

Uses 

Turpentine is applied to the skin to relieve pain and to 
withdraw blood from the deeper tissues; occasionally to 
form a blister. 

To increase the flow of urine. 

To expel gas from the intestines. 

To increase the cough and expectoration, and to check 
the growth of bacteria in the lungs. 

Administration 

For its effects on the skin, turpentine liniments are used, 
or it is applied in the form of a " stupe." 

Turpentine Stupe 
A turpentine stupe is applied by dipping a piece of flannel 



338 MATERIA MEDICA 

in hot water, to which a few drops of hot turpentine oil have 
been added. The flannel is wrung out, and applied over the 
skin, which should be covered with vaseline to prevent the 
formation of blisters. 

Internally, turpentine is best given in capsules or in an 
emulsion. As an expectorant, it is frequently given by in- 
halations. 

Turpentine is also often added to enemas to help the 
intestines to expel gas. 

Preparations 

Oil of Turpentine 0.3-1.0 c.c. m. v-xv 

(Oleum Terebinthinae) 

This is obtained by distilling turpentine. 

Purified Oil of Turpentine 0.3-1.0 c.c. m. v-xv 

(Oleum Terebinthinae Rectificatum) 

Emulsion of Turpentine Oil 4.0 c.c. 5i 

(Emulsum Olei Terebinthinae) 

Turpentine Liniment 
(Linimentum Terebinthinae) 

UVA URSI (BEAR BERRY) 

Uva ursi is obtained from the leaves of the Arctostaphylos 
uva ursi, an evergreen shrub growing in northern Europe 
and the United States. Its active principles are the gluco- 
sides, arbutin and methylarbutin. It also contains an in- 
active glucoside ericolin, and small quantities of tannic and 
gallic acids. 

ACTION 

Because of the tannic and gallic acids which it contains, 
uva ursi contracts mucous membranes. 

The principal action of uva ursi, however, is to increase 
the flow of urine, by directly increasing the activity of the 
kidney cells. This effect is due to the arbutin which it 
contains. It also acts as an antiseptic on the mucous mem- 
branes of the ureter, bladder and urethra. 



DIURETICS 339 

Preparations 

Fluidextract of Uva Ursi 1.0-4.0 c.c. m. v-xv 

(Fluidextractum Uvae Ursi) 

CHIMAPHILA (PIPSISSEWA) 

Chimaphila is obtained from the leaves of Chimaphila 
umbellata, an American plant. Its active principles are 
the ghicosides arbutin, and chimaphilin, another crystalline 
substance. It also contains some tannic and gallic acids. 

ACTION 

Chimaphila produces the same effects as uva ursi. It 
contracts the mucous membranes and increases the flow of 
urine. 

Preparations 

Fluidextract of Chimaphila 2.0-4.0 c.c. 5i~i 

(Fluidextractum Chimaphilae) 

ZEA (CORNSILK) 

Zea is obtained from the silky threads of the Zea mays 
or Indian corn or maize. 

ACTION 

Zea increases the flow of urine and acts as an antiseptic 
on the mucous membranes of the ureter, bladder and urethra. 

Preparations 

Fluidextract of Zea 4.0-8.0 c.c. 5i-ii 

(Fluidextractum Zeae) 

TRITICUM 

Triticum is obtained from the Agropyron repens, or couch 
grass, a grass which grows in Europe and the United States. 

ACTION 

Triticum is said to increase the flow of urine. It is usually 
given in the form of a decoction about 8.0-16.0 c.c. (3ii-iv) 
in a large tumbler full of water. 



340 MATERIA MEDICA 

Preparations 

Fluidextract of Triticum 2.0-4.0 c.c. 5H 

(Fluidextractum Tritici) 

ASPARAGIN (not official) 

This is a substance which is contained in asparagus and 
marshmallow root. It increases the flow of urine, and is 
given in doses of 0.03-0.06 gm. (gr. J-i). 

CORONILLIN 

This is the active glucoside of Coronilla scorproides. It 
is used to increase the flow of urine and to strengthen the 
heart action. It is given in doses of 0.06-0.3 gm. (grs. i-v). 

SALINE DIURETICS 

The following mineral salts are frequently used to increase 
the flow of urine. Most of them are salts of the alkalis and 
are used to produce other effects. 

ACTION 

The salts belonging to this group affect principally the 
stomach, intestines and the kidneys. 

Action in the stomach: Because of their alkaline reaction, 
these salts neutralize the acid in the stomach. 

Action in the intestines: Most of these salts act as cathar- 
tics. They produce frequent fluid movements of the bowels. 
For this effect they must be given in somewhat larger doses 
than usual. 

Action on the kidneys: The effect of these salts on the 
kidney is to increase the flow of urine. This effect results 
after they are absorbed, and are not produced by those 
salts which are not readily absorbed. 

Preparations 
Salts of Potassium 

Potassium Acetate 0.6-4.0 gms. grs. x-5i 

(Potassii Acetas) 



DIURETICS 341 

This is a salt of potassium and acetic acid. 

Potassium Bitartarate 0.6-4.0 gms. grs. x-3i 

(Potassii Bitartaras) 
(Cream of Tartar.) 

This is a salt of potassium and tartaric acid. It is usually 
given in hot water, flavored with lemon juice. It is rarely 
given alone, usually together with the infusion of juniper. 

Potassium Citrate 0.6-1.2 gm. grs. x-xx 

(Potassii Citras) 

This is not as unpleasant to take as the other potassium 
salts. It increases the secretion of sweat (diaphoretic ac- 
tion), as well as the secretion of urine. 

Solution of Potassium Citrate 15.0-30.0 c.c. 5^-i 
(Liquor Potassii Citratis) 

This contains about 8% of potassium bicarbonate, and 
about 6% of citric acid. 

Effervescent Potassium Citrate 2.0-4.0 c.c. 3-J-i 

(Potassii Citras Effervescens) 

This consists of potassium citrate 20%, potassium bicar- 
bonate and sugar. 

Effervescent Draught 

(Not official) 

This is made by adding 30.0 gms. (5i) of potassium bicar- 
bonate to 30.0 gms. (Si) of lemon juice. 

Other potassium salts which are occasionally used as 
diuretics, are potassium bicarbonate, potassium carbonate, 
potassium chlorate and potassium sulphate. 



Salts of Sodium 

The only salt of sodium that is used to increase the flow 
of urine, is sodium acetate. 

Sodium Acetate 0.6-4.0 gms. grs. x-3i 

(Sodii Acetas) 



342 MATERIA MEDICA 

Salts of Lithium 

The salts of lithium produce the same effects as the po- 
tassium salts. 

Their principal effect is to increase the flow of urine. 

They are said to dissolve crystals in the urine and to 
prevent the formation of stones in the kidney in this way. 

Preparations 

Lithium Benzoate 0.3-1.0 gm. grs. v-xv 

(Lithii Benzoas) 

Lithium Carbonate 0.3-1.0 gm. grs. v-xv 

(Lithii Carbonas) 

Lithium Citrate 0.3-1.0 gm. grs. v-xv 

(Lithii Citras) 

Effervescent Lithium Citrate 4.0-8.0 gms. 5i-ii 
(Lithii Citras Effervescens) 

This contains citric acid, lithium carbonate, sodium bi- 
carbonate and sugar. 

Salts of Strontium 

Strontium lactate is the only salt of strontium which in- 
creases the flow of urine. 

Strontium Lactate 0.3-1.0 gm. grs. v-xv 

(Strontii Lactas) 

THE NITRATES 

The nitrates are salts formed by the combination of nitric 
acid and an alkali. 

ACTION 

The nitrates are very cooling, and increase the flow of 
urine; and occasionally the secretion of sweat. 

Poisonous Effects 

Overdoses of the nitrates often cause the following symp- 
toms. 



DIURETICS 343 

1. Burning pain in the throat, and in the abdomen. 

2. Nausea and vomiting; the vomited matter often con- 
tains blood. 

3. Diarrhoea, with bloody stools. 

4. Profuse secretion of urine, or scanty urine. 

5. Great muscular weakness. 

6. Collapse, coma and death. 

Preparations 

Potassium Nitrate 0.3-2.0 gms. grs. v-xxx 

(Potassii Nitras) 

(Saltpeter) 

This preparation is the one which is commonly used. It 
is found in salt beds and caves in India and the United 
States. 

Sodium Nitrate 0.3-2.0 gms. grs. v-xxx 

(Sodii Nitras) 

PIPERAZINE 

Piperazine is a substance formed by the combination of 
ammonia and ethylene bromide. 

ACTION 

It increases the flow of urine and is said to dissolve the 
crystals which form stones in the kidney. It is frequently 
used as a remedy in gout. 

Preparations 

Piperazine 0.3-0.6 gm. grs. v-x 

(Piperazinum) 

MERCURY SALTS 

The following salts of mercury are often used to increase 
the flow of urine. 

Calomel 0.015-0.15 gm. grs. 1-ii 

(Hydrargyri Chloridi Mite) 



344 MATERIA MEDICA 

As a diuretic, calomel is often given in the form of Guy's 
or FothergilPs pill. 
This contains: 

Calomel 

Powdered squills. 

Powdered digitalis of each 0.06 gm. gr. i 
Bichloride of mercury, in small doses also increases the 
flow of urine. In poisonous doses, it causes severe destruc- 
tion of the kidney cells with lessened secretion of urine. 
Uraemia and death result from this condition. 

SPIRIT OF NITROUS ETHER 

This preparation increases the flow of urine, if the skin 
surface is kept cool. It produces other important effects 
however, under which it will be considered. 

Spirits of Nitrous Ether or Sweet 

Spirit of Niter 4.0-16.0 c.c. 5i-iv 

(Spiritus Aetheris Nitrosi) 

URINARY ANTISEPTICS ACTING AS DIURETICS 

The following drugs act as antiseptics in the kidney, 
bladder and urethra. They also increase the flow of urine. 

Urotropin 

Methylene Blue 

Buchu 

Oil of Erigeron 

Oil of Santal 

Copaiba 

Cubebs 

Matico 

The following drugs are principally used locally but they 
also increase the flow of urine. 

Cantharides 
Turpentine Oil 



PART HI— DEPRESSANTS 

CHAPTER XV 

CARDIAC AND VASCULAR DEPRESSANTS 

The most important effect of the following group of drugs 
is to lessen the action of the heart. (See page 152 for heart 
depression.) 

ACONITE (MONEYS HOOD OR WOLFSBANE) 

Aconite is obtained from the root of Aconitum napellus, 
monk's hood or wolfsbane, a perennial plant growing in the 
mountainous regions of Europe and Asia. The root often 
resembles horse-radish in appearance. The active principle 
of aconite, is the alkaloid aconitine. There are other species 
of aconite which contain several similar alkaloids such as 
pseudaconitine and japaconitine, which produce the same 
effects as aconitine. 

Appearance of the Patient 

When an average dose of aconite is given, the patient's 
mouth and throat feel warm, and he often complains of 
slight numbness and tingling of the lips, tongue and throat, 
or even in the extremities. The pulse is slower and some- 
what weaker, and the breathing is usually slow and shallow. 
The temperature is lowered and the patient often feels quite 
weak. 

ACTION 

Local action: Applied to the skin or mucous membranes, 

aconite or aconitine causes a prickling or tingling sensation. 
This is due to the greater sensitiveness of the nerve endings 
in the skin or mucous membranes. The ordinary sensations 
of touch are then felt as prickling or tingling sensations. 

345 



346 MATERIA MEDICA 

Soon however, these nerve endings are paralyzed, and the 
skin or mucous membranes feel numb. Very often this 
increased sensitiveness causes various reflex actions. For 
example — when aconite is applied to the mucous membrane 
of the nose, it causes sneezing. Increased flow of saliva, 
vomiting and coughing also often result from the local ap- 
plication of aconite to mucous membranes. 

Internal Action 

In the mouth: Aconite has a bitter taste and causes a 
prickling and tingling sensation followed by numbness in 
the mouth and throat. This effect on the nerve endings in 
the mouth, causes a reflex flow of saliva. 

In the stomach and intestines: In the doses that aconite 
is usually given, it produces no effect. In larger doses, how- 
ever, it often causes nausea and vomiting by the reflex con- 
tractions of the muscles of the stomach and intestines, as a 
result of the greater sensitiveness of their nerve endings. 

Action after Absorption 

Aconite is absorbed into the blood stream through the 
lining membrane of the stomach, usually in about half an 
hour after it is given. After absorption, it acts principally 
upon the heart, the respiration, the nerve endings and the 
temperature. 

Action on the heart: Aconite makes the heart beat slower 
and weaker, and lessens the blood pressure. The effect on 
the heart is due to the greater number of impulses which are 
sent to the heart from the cardio-inhibitory center in the 
medulla of the brain, along the Vagus or inhibitory nerves. 

The pulse of aconite is usually slow, weak, soft and com- 
pressible. 

Action on the respiration: Aconite makes the breathing 
slower but somewhat deeper and more difficult. The slow 
breathing is due to the fewer impulses for breathing which 
are sent from the respiratory center in the medulla. 

Action on the nervous system: Aconite does not act on 
the brain, but it produces important effects as a result of 
its action on the nerve endings. 



CARDIAC AND VASCULAR DEPRESSANTS 347 

Action on the nerve endings: Aconite, either when taken 
internally, or when applied locally, makes the sensory nerve 
endings of the skin and mucous membranes more sensitive 
at first, and later paralyzes them. This produces the ting- 
ling and prickling sensations, followed by numbness, which 
are so characteristic of aconite. 

The muscular weakness produced by aconite in large doses, 
is due to its effect on the nerve endings in the muscles. 

Action on the secretory glands: Aconite increases the 
secretion of sweat and saliva, and it is said to increase the 
flow of urine. 

Effect on temperature: It reduces temperature by in- 
creasing the elimination of heat. 

Excretion 

Aconite is eliminated from the body in about three or 
four hours after it is given, mainly by the urine. 

Poisonous Effects 

Since aconite is rapidly excreted, only acute aconite poi- 
soning occurs, usually from the administration of an over- 
dose. 

Aconite is one of the few poisons which causes death very 
rapidly. If a sufficiently large dose is taken, the patient 
may die immediately, from sudden paralysis of the heart. 
Usually, however, the symptoms appear very rapidly and 
the patient dies in about three or four hours. 

Symptoms 

The first, and diagnostic symptom of aconite poisoning 
is: 

1. The characteristic tingling and prickling sensation on 
the lips, mouth and throat, and a smarting tingling feeling 
of the skin of the extremities, soon followed by numbness. 

Associated with these symptoms are: 

2. Profuse flow of saliva. 

3. Nausea and vomiting. 

4. Great muscular weakness. 



348 MATERIA MEDICA 

5. Slow, irregular, weak pulse. 

6. Slow, shallow, difficult, irregular breathing. 

7. Collapse (cold, moist skin; anxious face; protruding eye- 
balls with dilated pupils; rapid, thready, very weak pulse). 

8. Often there are convulsions and unconsciousness just 
before death. Usually however, consciousness remains 
to the last. Death usually results from paralysis of the 
respiration. 

Treatment 

To save a patient from aconite poisoning, quick action 
is necessary, as death results very rapidly. 

1. Wash out the stomach. 

2. Give atropine as an antidote. 

This prevents the slow weak heart action, by paralyzing 
the nerve endings in the heart, of the Vagus nerve, and it 
also makes the breathing faster and deeper. 

3. Keep the patient absolutely quiet, flat on his back, 
and lower the head by removing the pillows, and elevate 
the foot of the bed. Keep the patient warm. 

4. Give artificial respiration. 

5. Give heart stimulants such as caffeine, whiskey, am- 
monia, etc. 

Uses 

Aconite is now rarely used. It is principally given to 
reduce fever in acute infectious diseases. 

Preparations 

Fluidextract of Aconite 0.06-0.12 c.c. m. i-ii 

(Fluidextractum Aconiti) 

Tincture of Aconite 0.06-0.3 c.c. m. i-v 

(Tinctura Aconiti) 

This is the preparation commonly used. 

For Local Use 

Aconite Liniment (not official) 
(Linimentum Aconiti) 

This contains about 2% of aconite, and is an ingredient 



CARDIAC AND VASCULAR DEPRESSANTS 349 

of many patent medicines which are used to relieve the 
pains of chronic rheumatism. 

Aconite Ointment (not official) 
(Unguentum Aconiti) 

This contains 2% of aconite. 

Aconitine 

Aconitine 0.00015-0.0006 gm. gr. ?h> - ih 

(Aconitina) 

STAPHISAGRIA (STAVESACRE OR DELPHINIUM) 

Staphisagria or stavesacre is obtained from the dried 
ripe seeds of Delphinium staphisagria or stavesacre. 

Its active principle is an alkaloid delphinine, which pro- 
duces the same effects as Aconitine. 

Delphinine is used in the form of a tincture or ointment 
to destroy parasites such as lice. 

VERATRUM (AMERICAN HELLEBORE) 

Veratrum is obtained from the root and underground 
stems of the Veratrum viride, or green hellebore, a plant 
which grows in swampy places in the northern part of the 
United States. It is commonly known as American or swamp 
hellebore, or Indian poke. There is also another species 
of veratrum known as Veratrum album, or white hellebore. 

The active principles of veratrum, are the alkaloids vera- 
trine and protoveratrine. These alkaloids are very closely 
related to aconitine chemically, and they produce very 
similar effects. 

ACTION 

Local action: Applied to the skin, or mucous membranes, 
as in the form of an ointment, veratrum causes a tingling 
and prickling sensation, soon followed by numbness. This 
is due to the sensory nerve endings being made more sensi- 
tive and then paralyzed. In the nose, for example, the 
application of veratrum causes sneezing, as a result of the 
increased sensitiveness of the nerve endings. 



350 MATERIA MEDICA 

Internal Action 

In the mouth: Veratrum has a bitter taste, and by its 
effect on the nerve endings in the mouth, it causes a reflex 
flow of saliva. 

In the stomach: Veratrum often causes nausea and vomit- 
ing, by making the nerve endings in the stomach more 
sensitive, thereby increasing the reflex impulses for vomiting. 

In the intestines: It causes frequent movements of the 
bowels, probably by the reflex contractions of the intes- 
tinal muscles, as a result of the increased sensitiveness of 
the nerve endings in the mucous membrane. 

Action after Absorption 

Veratrum is rapidly absorbed from the stomach. After 
absorption it affects principally the heart, the respiration, 
the muscles and nerve endings. 

Action on the heart: Veratrum makes the heart beat 
slower and weaker, by increasing the impulses which slow 
the heart, that are sent out from the Vagus or inhibitory 
center in the medulla of the brain along the Vagus nerves. 
It also prolongs the period of relaxation which follows each 
period of contraction of the heart muscle. 

The pulse of veratrum is therefore slower, weaker, softer and 
more compressible. 

Action on the respiration: Veratrum makes the breathing 
slower, shallower and more difficult. 

Action on the muscles: It produces a peculiar and char- 
acteristic effect on voluntary muscles. It lengthens the 
period of relaxation which follows each contraction. 

Action on nerve endings: Veratrum produces the same 
tingling and numbness of the skin as aconite does, by first 
making the sensory nerve endings more sensitive, and then 
paralyzing them. 

The vomiting and diarrhoea often produced by veratrum 
are due to this action. 

Action on the secretory glands: It often causes an in- 
creased secretion of saliva and sweat. 

Effect on the temperature: Veratrum lowers the tem- 
perature by increasing the elimination of heat. 






CARDIAC AND VASCULAR DEPRESSANTS 351 

Excretion 
Veratrum is rapidly excreted, mainly by the urine. 

Poisonous Effects 

Poisoning from veratrum rarely occurs, since it causes 
such violent vomiting, that the drug is soon excreted in the 
vomited matter, and it is therefore rarely fatal. Occasion- 
ally, the following alarming symptoms occur: 

1. Tingling and numbness of the mouth, lips, and skin 
of the extremities. 

2. Profuse diarrhoea. 

3. Slow, weak, irregular pulse. 

4. Slow and shallow breathing. 

5. Occasionally dizziness. 

6. Restlessness. 

7. Muscular twitchings. 

8. Convulsions. 

9. Collapse 

The treatment is the same as for aconite poisoning. 

Uses 

Veratrum is occasionally used as a substitute for aconite. 

Preparations 

Fluidextract of Veratrum 0.06-0.3 c.c. m. i-v 

(Fluidextractum Veratri) 

Tincture of Veratrum 0.3-1.0 c.c. m. v-xv 

(Tinctura Veratri) 

VERATRINE 

Veratrine is a mixture of all the alkaloids found in Vera- 
trum sabadilla, or Asagraea officinalis, a Mexican plant known 
as cevadilla. The most important of these alkaloids are 
veratrine and protoveratrine, which are also found in veratrum 
viride. 

ACTION 

Veratrine produces the same effects as the veratrum viride, 
or its alkaloid veratrine, with the following slight differences. 



352 MATERIA MEDICA 

1. Veratrine is more poisonous and causes convulsions, 
and death from asphyxia. 

2. When locally applied, in addition to the tingling and 
numbness, it often causes blisters. 

Uses 

Veratrine is used principally to relieve pain in neuralgia, 
rheumatism, etc. 

Preparations 

Veratrine Ointment 
(Unguentum Veratrinae) 

This contains 4% of veratrine. 

Oleate of Veratrine 
(Oleatum Veratrinae) 

This contains 2% of veratrine. 

ARNICA 

Arnica is obtained from the flowers of the Arnica montana, 
or leopard's bane, a plant growing in northern Europe, 
Asia and the northwestern part of the United States. Its 
active principles are arnicin, an alkaloid, a volatile oil and 
several resinous substances. 

ACTION 

Local action: Applied to the skin, it causes redness and 
improves the circulation. It is said to cause the absorption 
of blood which has gathered in the tissues, after an injury 
or bruise (haematoma). 

Internal Action 

When arnica is taken internally, it makes the heart beat 
slower. It is also said to increase the secretion of sweat, and 
the flow of urine. It is excreted mainly by the urine. 

Poisonous Effects 

Arnica should never be applied to an open wound, as it 
often produces poisonous symptoms from such applications. 



CARDIAC AND VASCULAR DEPRESSANTS 353 

Symptoms 

1. Nausea, vomiting and diarrhoea. 

2. Collapse (rapid, thready pulse, cold skin, shallow 
breathing, etc.). 

Preparations 

Tincture of Arnica 0.3-2.0 c.c. m. v-xxx 

(Tinctura Arnicae) 

This preparation is rarely used internally in this country. 
It is principally used locally on sprains, bruises, etc. It 
should be diluted and then applied on a piece of flannel, 
which is then covered with a bandage. 

Other Cardiac Sedatives 

The following drugs also lessen the heart action, but 
they have other more important effects under which they 
will be described. 

They cause slow, weak contractions of the heart, produc- 
ing a slow, weak pulse. 

Eserine or Physostigmine 

Pilocarpine 

Grindelia 

Lobelia 

Dilute Hydrocyanic Acid 






VASO-DILATORS 

The following drugs act principally on the blood-vessels. 
They lessen the contractions of the small muscle fibers in 
their walls, so that the blood vessels are then widened. As 
a result of this action, various effects are produced upon 
various organs and tissues of the body. 

THE NITRITES 

The nitrites are salts formed by the combination of ni- 
trous acid with an alkali, or an organic substance such as 
an alcohol, as amylic alcohol. The most important com- 
pounds formed in this way, are amyl nitrite and nitro- 
glycerine. The former of these substances produces rapid 
effects which soon pass off, while the latter drug produces 
slower effects which are more lasting. 

AMYL NITRITE 

Amyl nitrite is a yellow fluid which evaporates easily, 
and has a characteristic odor of fruit. It is made by dis- 
tilling nitric acid with amylic alcohol, sulphuric acid and 
copper, and then purifying the resulting liquid. 

Appearance of the Patient 

About three to five minutes after an average dose of amyl 
nitrite is inhaled, the face becomes flushed, and sometimes 
the skin all over the body as well. The patient complains 
of fullness and throbbing in the head, and often of severe 
headache. The pulse is rapid, soft and bounding, and the 
breathing is rapid and somewhat deeper. These symptoms 
last for about ten to fifteen minutes, and then pass off. 

ACTION 

Amyl nitrite causes no local effects, and since it is usually 
given by inhalation, it produces no effects in the stomach and 
intestines. 

354 



CARDIAC AND VASCULAR DEPRESSANTS 355 

Action after Absorption 

Amyl nitrite is inhaled into the lungs. There, it is ab- 
sorbed into the blood through the lining membrane of the 
lungs, usually in about five minutes. After absorption, it 
affects principally the blood vessels, the heart, the respira- 
tion and the blood. 

Action on the circulation: Amyl nitrite does not affect 
the heart directly, but by means of its action on the blood 
vessels. 

Action on the blood vessels: Amyl nitrite affects prin- 
cipally the blood vessels. It paralyzes the small involun- 
tary muscle fibers in the walls of the small blood vessels. 
As a result of this action, these blood vessels are widened, 
so that it is easier for the blood to pass through them, and 
the blood pressure is lessened. The heart does not then 
have to contract so forcibly, because the blood moves along 
more freely, and it does not need much propelling force, 
since the blood vessels are wider. The heart contracts faster, 
however, because the wider blood vessels offer very little 
resistance to the contractions of the heart, which then con- 
tracts with greater ease. By this action on the blood ves- 
sels, amyl nitrite eases the action of the heart, and relieves 
it, when it is overworking because of increased blood pres- 
sure, or spasmodic contractions of the blood vessels. 

The blood vessels of the abdomen and head are more 
affected than those of the extremities. The widened blood 
vessels of the face and head, cause the flushed face, the full- 
ness and throbbing in the head, which are so characteristic 
of amyl nitrite action. 

The total effect of amyl nitrite on the circulation is to 
make the heart beat faster, and to lower the blood pressure. Its 
characteristic pulse is rapid, soft and bounding, with low 
blood pressure. The bounding quality of the pulse is quite 
characteristic of amyl nitrite, and is due to the widened 
blood vessels, which allow the contractions of the heart to 
be more easily transmitted. 

Action on the respiration: Amyl nitrite makes the breath- 
ing faster and deeper. 



356 MATERIA MEDICA 

Action on the nervous system: Amyl nitrite does not affect 
the brain directly. The headache, fullness and throbbing 
sensation in the head, and the slight confusion so character- 
istic of amyl nitrite are due to the widened blood vessels in 
the brain; which then contains more blood (congestion). 

Effect on sight: In some people, the sense of sight is pecul- 
iarly affected by amyl nitrite. Dark objects seem to be sur- 
rounded by a yellow ring, and this again by a blue one. 

Effect on temperature: The temperature is lowered by 
amyl nitrite, because of the widened blood vessels in the 
skin, which increases the elimination of heat. 

Action on the kidneys: It increases the flow of urine by 
dilating the blood vessels of the kidneys; which then con- 
tain more blood, and are therefore able to secrete more urine. 
The urine sometimes contains sugar. 

Excretion 

Amyl nitrite is very rapidly eliminated from the body, 
usually within a half hour; mainly by the kidneys. It is 
excreted in the urine as various salts, such as nitrites and 
nitrates. 

Poisonous Effects 

Overdoses of amyl nitrite usually cause the following 
symptoms: 

1. Slow, weak and irregular pulse. 

2. Slow and shallow breathing. 

3. The blood has a dark chocolate color, due to the forma- 
tion of methaemoglobin, which prevents the haemoglobin 
from combining with oxygen. 

4. Intense headache. 

5. Dizziness. 

6. Dilated pupils. 

7. Occasionally convulsions occur. 

8. Collapse (slow, very weak pulse, slow and shallow 
breathing, cold, moist skin, etc.). 

Treatment 

Amyl nitrite is rarely fatal, the poisonous symptoms usu- 
ally disappear when the drug is stopped. 



CARDIAC AND VASCULAR DEPRESSANTS 357 

1. Give artificial respiration. 

2. Give heart stimulants such as caffeine, strychnine, etc. 

Administration 

Amyl nitrite is usually given by inhalation. It comes in 
small glass "pearls," each containing about 0.2-0.3 c.c. 
(m. iii-v) of amyl nitrite, which are broken in a handker- 
chief and then applied to the nose of the patient. The 
handkerchief should be withdrawn as soon as the effects 
are produced. Amyl nitrite is occasionally given hypoder- 
mically. It is also given by the mouth; about 0.2-0.3 c.c, 
(m. iii-v) dropped on a piece of sugar; but the effects then 
appear very slowly. 

Uses 

Amyl nitrite is used: 

1. To relieve an attack of "angina pectoris/' a disease 
characterized by attacks of severe pain around the heart, 
and shooting pains into the arms. This disease is due to 
the spasmodic contractions of the muscle wall of the coronary 
arteries in the heart. (These vessels supply the heart muscle 
with blood.) Amyl nitrite relieves these attacks by relaxing 
the spasms of these blood vessels. 

2. To relieve an attack of bronchial asthma; by relaxing 
the spasm of the involuntary muscles in the walls of the 
bronchi. 

Preparations 

Amyl Nitrite 0.15-0.3 c.c. m. ii-v 

(Amylis Nitris) 

This comes in small glass capsules (pearls) each contain- 
ing the required dose. It should always be fresh; as it de- 
composes very easily. 

NITROGLYCERIN AND OTHER NITRITES 

Nitroglycerin or spirits of glonoin, is a colorless, oily 
liquid which has an odor and taste like alcohol. Nitro- 
glycerin combined with porous silica forms dynamite. Prep- 
arations of nitroglycerin should be very carefully handled, 



358 MATERIA MEDICA 

as it is apt to explode when dropped on the floor, when 
•heated, or when rubbed vigorously. If it is accidentally 
spilled, it should be destroyed immediately, by pouring 
potassium hydroxide solution over it. 

A 1% alcoholic solution is used as a medicine, which 
should always be kept cool, as it may explode when exposed 
to heat. 

Appearance of the Patient 

About five minutes after taking an average dose of nitro- 
glycerin, the patient complains of a feeling of fullness in 
the head, with frontal headache, and occasionally dizziness. 
The face is flushed, the pulse is rapid, soft and bounding, 
and the blood pressure is diminished. The breathing is 
faster and deeper. These effects last about three-quarters 
to one hour, and then wear off. The headache may remain 
for several hours, however. 

ACTION 

The effects of nitroglycerin are similar to those of amyl 
nitrite, but they are more lasting. 

Local action: Nitroglycerin may redden the skin or mu- 
cous membranes if applied locally. 

Internal Action 

In the mouth: Nitroglycerin has a pungent taste. 

In the stomach: It causes a sense of warmth. Since it 
is rapidly absorbed from the stomach, it produces no effects 
in the intestines. 

Action after Absorption 

Nitroglycerin is very rapidly absorbed into the blood, 
through the lining membrane of the stomach, usually in 
about five to ten minutes. After absorption, it affects prin- 
cipally the blood vessels, the respiration and the kidneys. 

Action on the blood vessels: Nitroglycerin widens the 
blood vessels, by paralyzing the muscle fibers in their walls. 
This lessens the blood pressure, and eases the work of the 
heart; which then beats faster. The pulse after nitroglycerin 



CARDIAC AND VASCULAR DEPRESSANTS 359 

is rapid, soft and bounding and the blood pressure is low. It 

is often dicrotic. 

Action on the respiration: It makes the breathing faster 
and deeper. 

Action on the nervous system: Nitroglycerin does not 
affect the nervous system directly. The headache, the full- 
ness in the head and the occasional dizziness, are due to the 
dilated blood vessels in the brain, which then contains more 
blood (congestion), and gives rise to these sensations. 

Effect on temperature: The temperature is somewhat 
lowered. 

Action on the kidneys: The flow of urine is often increased 
by nitroglycerin, when the kidneys do not secrete a sufficient 
amount of urine, because of the lessened blood pressure. The 
better circulation of blood in the kidneys as a result of the 
widened blood vessels, increases the secretion of urine. 

Excretion 

Nitroglycerin is excreted by the urine, usually in about 
one or two hours. 

Poisonous Effects 

Poisoning from nitroglycerin, usually occurs in two forms, 
acute poisoning, and chronic poisoning or cumulative symp- 
toms. 

Acute Poisoning 

This usually results from a single overdose of nitroglycerin. 

Symptoms 

1. Slow, weak, irregular pulse. 

2. Slow and shallow breathing. 

3. Intense headache. 

4. Dizziness. 

5. Dilated pupils. 

6. Occasionally convulsions. 

7. Collapse. 

These symptoms have resulted from as little as two to 
ten drops of nitroglycerin. 



360 MATERIA MEDICA 

Treatment 

1. Give heart stimulants, such as caffeine, strychnine, 
digalen, etc. 

2. Give artificial respiration if necessary. 

Chronic Poisoning or Cumulative Symptoms 

Since nitroglycerin is often given in repeated doses for a 
long time, poisonous symptoms may come on gradually, 
which indicate that the patient is getting too much of the 
drug, and it should then be stopped. 

Symptoms 
(In the order of their onset) 

1. Intense headache. 

2. Feeling of a tight band around the head. 

3. Dizziness. 

4. Constriction of the throat. 

5. Nausea and feeling of weakness in the region of the 
stomach. 

6. Slow, irregular pulse. 

7. Slow, shallow, breathing. 

When the drug is stopped, these symptoms usually dis- 
appear. 

Uses 

Nitroglycerin is given principally in repeated doses for a 
long time, in the following conditions. 

1. Arteriosclerosis or hardening of the arteries. 

It relaxes the contractions of the arteries whose muscle 
fibers have not yet been replaced by connective tissue. In 
many cases nitroglycerin produces no effect, as the muscle 
fibers have been replaced by fibrous tissue, which cannot 
relax. 

2. To reduce blood pressure, in nephritis. 

3. To relax the contractions of the involuntary muscles 
in the bronchi, in asthma. 

4. To prevent the attacks of angina pectoris by keeping 
the muscles of the coronary blood vessels of the heart relaxed. 



CARDIAC AND VASCULAR DEPRESSANTS 361 

Administration 

Nitroglycerin is given either in a 1% alcoholic solution, 
or in tablets; best after meals. It is suitable in conditions 
where continual effects from the nitrites are desired. Since 
this effect lasts for only an hour, it should be repeated fre- 
quently; about every hour. 

Preparations 

Spirits of Glyceryl Trinitrate 0.03-0.2 c.c. m. f-iii 
(Spiritus Glycerylis Nitratis) 
Nitroglycerin or Spirits of Glonoin 

This is a 1% alcoholic solution of nitroglycerin. It should 
always be fresh; as it decomposes very easily. 

Tablets of Nitroglycerin 0.0006 gm. gr. T ^ 

(Tabellae Trinitri) 

(Not official) 

1 to 2 tablets are given at a time. 

These are not as efficient as a solution of the drug, and 
they decompose very easily. 

SWEET SPIRITS OF NITER (SPIRITUS AETHERIS 
NITROSI) 

Sweet spirit of niter is a 4% solution of nitrous ether, or 
ethyl nitrite, in alcohol. It evaporates very easily and is 
inflammable. It should always be fresh; as old solutions 
decompose. 

ACTION 

Sweet spirit of niter produces the same effects as nitro- 
glycerin or the other nitrites. 

It dilates the blood vessels by paralyzing their muscle 
fibers, and causes: 

1. A rapid, soft, bounding pulse. 

2. Rapid breathing. 

3. Increased flow of urine, by relaxing the blood vessels 
of the kidneys. 

4. Increased secretion of sweat, by widening the blood 



362 MATERIA MEDICA 

vessels of the skin, so that the sweat glands are supplied 
with more blood from which to secrete perspiration. 

Poisonous Effects 

Inhalation of sweet spirit of niter has produced danger- 
ous, even fatal symptoms; resembling those produced by 
amyl nitrite. 

Symptoms 

1. Headache. 

2. Pain around the heart. 

3. Weak, slow pulse. 

4. Slow, shallow breathing. 

5. Muscular weakness. 

6. Collapse. 

Uses 

Sweet spirit of niter is used to increase the sweat and 
thereby to reduce fever, especially in children. It is given in 
small doses, well diluted; and the patient should be kept in 
bed, warmly covered. If the skin is kept cool, it increases 
the flow of urine. 

Preparations 

Spirits of Nitrous Ether 1.0-4.0 c.c. 3H 

(Spiritus Aetheris Nitrosi) 
Sweet Spirit of Niter 



SODIUM AND POTASSIUM NITRITES 

Sodium and potassium nitrites are salts formed by the 
combination of sodium or potassium, with nitrous acid. 

They produce the same effects as amyl nitrite or nitro- 
glycerin, with the following variations. 

1. Their effects appear very slowly, usually in about a 
half hour, but they last for several hours. 

2. They often cause nausea, belching of gas, and pain in 
the stomach, and occasionally diarrhoea. 

3. They do not cause as much headache, or flushing of 
the face as amyl nitrite or nitroglycerin does. 



CARDIAC AND VASCULAR DEPRESSANTS 363 

Uses 

The nitrite of either sodium or potassium, is suitable for 
continued use, to lower the blood pressure. 

Preparations 

Sodium Nitrite 0.06-0.12 gm. grs. i-ii 

(Sodii Nitras) 

This is given in solution or in tablets. 

Potassium Nitrite 0.06-0.12 gm. grs. i-ii 

(Potassii Nitras) 

This is not official and is rarely used. 

New and Non-official Preparations of the Nitrites 

Erythrol Tetranitrate 0.03-0.06 gm. gr. £-i 

(Tetranitrol) 

Mannitol Hexanitrate 0.03-0.06 gm. gr. |-i 

These preparations are given in tablets, because they are 
explosive in fluid form. 

ACTION 

These preparations produce the same effects as nitro- 
glycerin, but they are more lasting. The effects usually 
appear in about 15 minutes and last for about 3 or 4 hours. 



CHAPTER XVI 

RESPIRATORY DEPRESSANTS 

The following drugs make the breathing slower and shal- 
lower. They have already been described, or they will be 
described later, under their more important effects. 

Opium 

Morphine 

Codeine 

Bromides 

Chloral 

Trional 

Tetronal 

Veronal 

Sulphonal 

Paraldehyde 

Amylene hydrate and other similar hypnotics 

The following drugs are used principally to check exces- 
sive coughing and make the breathing slower and shallower. 

DILUTE HYDROCYANIC ACID (DILUTE PRUSSIC ACID) 

Dilute hydrocyanic acid, or acidum hydrocyanicum dilu- 
tum, is a 2% solution of pure hydrocyanic or prussic acid. 
It is formed by the combination of hydrochloric acid and 
silver cyanide. It is a colorless inflammable fluid which 
evaporates very easily. Hydrocyanic acid is the most poi- 
sonous substance known. The inhalation of its fumes, causes 
instant death. Scheele, the chemist who discovered it, is 
said to have died from inhaling its fumes. 

Bitter almonds, and the kernels of the seeds of various 
fruits such as peaches, cherries, apricots, plums and 
prunes, contain a glucoside amygdalin and a ferment emulsin. 
When these kernels are rubbed in water, the emulsin changes 

364 



RESPIRATORY DEPRESSANTS 365 

the amygdalin into prussic acid, glucose (a sugar) and an- 
other substance. The syrup of wild cherry bark (Syrupus 
pruni virginianae) also contains very small quantities of hydro- 
cyanic acid. 

ACTION 

Hydrocyanic acid is rarely used except as an ingredient 
of cough mixtures, to lessen coughing. 

Local action: Hydrocyanic acid causes numbness of the 
skin or mucous membranes, if applied locally to them, by 
paralyzing their sensory nerve endings. It is often ab- 
sorbed from the injured skin, and may then cause poisonous 
symptoms. 

Internal Action 

When taken internally, it has a bitter taste, it increases 
the flow of saliva, and causes a sense of warmth in the 
stomach and intestines. It is readily absorbed from the 
stomach in about 15 to 20 minutes and it then produces the 
following effects. 

Action on the respiration: It makes the breathing slower 
and shallower by lessening the impulses for breathing, which 
are sent out from the respiratory center in the medulla. 
In this way, it lessens coughing. 

Action on the heart: It makes the heart beat slower, by 
sending more impulses to the heart from the Vagus or inhib- 
itory center of the medulla. It also weakens the contrac- 
tions of the heart muscle. 

Action on the blood vessels: It contracts the blood vessels, 
thereby increasing the blood pressure for a very short time. 
The blood vessels soon dilate, however, and the blood pres- 
sure is lessened. 

The characteristic pulse of hydrocyanic acid, then, is slow, 
at first strong, but it soon becomes weak. 

It has a very important effect on nutrition. 

Action on nutrition: It prevents the tissues from com- 
bining with oxygen, and thereby obtaining nourishment. 
It is for this reason, that the blood in the veins has a bright 
red color like that of the blood in the arteries. The tissues 
have not been able to take away the oxygen from the haemo- 



366 MATERIA MEDICA 

globin of the arterial blood, and the blood in the veins con- 
tains the haemoglobin still combined with the oxygen. 

Excretion 

Hydrocyanic acid is rapidly eliminated by the kidney, 
combined with sulphur, as sulphocyanides, and also by the 
lungs. 

Poisonous Effects 

Hydrocyanic acid is the most poisonous substance known. 
When it is administered, the patient should be watched 
carefully for symptoms of excessive action. 

Excessive Effects 

Overdoses of dilute hydrocyanic acid cause the following 
symptoms. 

1. Nausea and vomiting. 

2. Headache. 

3. Dizziness. 

4. Faintness. 

5. Muscular weakness. 

6. Slow, weak pulse. 

7. Slow, shallow, difficult breathing. 

8. Dilated pupils with protruding eyeballs. 

9. Occasionally the face becomes bloated. 

10. Stupor. 

These symptoms disappear when the drug is stopped, 
and heart and respiratory stimulants administered. 

Hydrocyanic Acid Poisoning 

Hydrocyanic poisoning usually results when this acid, or 
any of its salts are taken with suicidal intent, or by the in- 
halations of its fumes in a chemical laboratory. It is the 
most powerful poison known. 

Symptoms 

When a sufficiently large dose is taken, there is a slight 
convulsion and death results immediately from paralysis 
of the heart and respiration. 



RESPIRATORY DEPRESSANTS 367 

If the dose has not been very large, the following symp- 
toms appear in a few seconds. 

1. The patient falls to the ground unconscious. 

2. Bloated face and frothing at the mouth. 

3. Protruding eyeballs. 

4. Dilated pupils. 

5. Very slow, shallow and irregular breathing. Often the 
expiration is prolonged, and followed by a long pause, during 
which the breathing seems to have stopped. 

6. Very weak and irregular pulse. 

7. Cyanosis. 

8. Odor of acid on the breath. 

9. Cold, moist skin. 

10. Convulsions with clinching of the muscles of the 
fingers and toes. 

11. Paralysis of the muscles. 

Death usually results from paralysis of the respiration, 
within fifteen minutes. 



Treatment 

Rapid, vigorous treatment is necessary in order to save 
the patient. Usually, however, the symptoms appear so 
rapidly, that death results in spite of the most active treat- 
ment. If the patient can be kept alive from about twenty 
minutes to a half hour, the chances of recovery are increased ; 
as most of the drug is then excreted. 

1. Give artificial respiration continuously, as long as the 
patient is alive. This helps to get rid of the drug by the 
lungs. 

2. Apply cold applications to the head and spine to keep 
up the breathing. 

3. Give iron hydroxide or peroxide of hydrogen to neu- 
tralize the acid. 

4. Wash out the stomach. 

5. Give heart and respiratory stimulants, intravenously, 
or hypodermically. The best ones to use are: atropine, 
strychnine, caffeine, ammonia, ether, alcohol, etc. 



368 MATERIA MEDICA 

Preparations 

Dilute Hydrocyanic Acid 0.1-0.5 c.c. m. ii-viii 

(Acidum Hydrocyanicum Dilutum) 

This contains 2% of hydrocyanic acid. It should always 
be fresh; as it decomposes very easily. 

POTASSIUM CYANIDE 

Potassium cyanide is a salt formed by potassium with 
hydrocyanic acid. 

ACTION 

Local action: Applied to the skin, it causes redness and 
inflammation. If the skin surface is injured, it may be ab- 
sorbed and then cause poisonous symptoms. 

Internal Action 

When potassium cyanide enters the stomach, the acid 
of the gastric juice decomposes it, and hydrocyanic acid is 
formed. The effects which are then produced are those of 
hydrocyanic acid. 

Poisonous Effects 

The poisonous symptoms of potassium cyanide, are the 
same as those of hydrocyanic acid, but they appear more 
slowly and do not cause death so rapidly. 

The treatment is the same as for hydrocyanic acid poison- 
ing, but in addition to the other measures used, a weak 
solution of iron sulphate occasionally neutralizes the effect, 
by forming prussian blue (potassium ferrocyanide), which 
is an inactive substance. 

Uses 

Potassium cyanide is occasionally used as a substitute for 
hydrocyanic acid. It is frequently used in i-1% solutions 
to remove the stains of silver nitrate from the skin. 

Preparations 

Potassium Cyanide 0.005-0.008 gm. gr. t Vt 

(Potassii Cyanidum) 



RESPIRATORY DEPRESSANTS 369 

OXAPHOR (not official) 

Oxaphor is a 50% solution of oxycamphor, a derivative 
of camphor. Its principal effect is to make the breathing 
slow and shallow. 

It is used as a substitute for morphine in asthma, and 
difficult breathing (dyspnoea) from other causes. 

Oxaphor 2.0-3.0 gms. grs. xxx-xlv 

SEDATIVE EXPECTORANTS 

The following drugs are used principally to relieve spas- 
modic cough. 

GRINDELIA 

Grindelia is obtained from the leaves and flowers of 
Grindelia robusta, and Grindelia squarrosa, plants which grow 
on the western coast of the United States. 

ACTION 

The principal effects of grindelia are the following: 

1. It lessens spasmodic cough by relaxing the contrac- 
tions of the involuntary muscles of the bronchi. 

2. It makes the heart beat slower and weaker, causing a 
slow and weak pulse. 

3. It increases the flow of urine. 
Grindelia is excreted mainly by the urine. 

Poisonous Effects 

Overdoses of grindelia cause the following symptoms : 

1. Nausea and vomiting. 

2. Slow, weak pulse. 

3. Slow, shallow breathing. 

4. Subnormal temperature. 

5. Stupor. 

6. Dilated pupils. 

Uses 

Grindelia is used to relieve spasmodic cough in whooping 
cough and asthma. It is also used locally to relieve poison 
ivy rash. 



370 MATERIA MEDICA 

Preparations 

Fluidextract of Grindelia 1.0-4.0 c.c. m. xv-5 i 

(Fluidextractum Grindeliae) 

LOBELIA 

Lobelia or Indian tobacco, is occasionally used to relieve 
the spasmodic cough of whooping cough and asthma. It 
is a dangerous drug, and the patient should be carefully 
watched when it is given. Its action will be described under 
its more important effects. (See page 464.) 



CHAPTER XVII 

CEREBRAL DEPRESSANTS 

Cerebral depressants are drugs which lessen the activity 
of the brain. 

The following drugs lessen the activity of the brain. Some 
of these drugs lessen all the functions of the brain, while 
others lessen only some activities, and increase others. For 
the mode of action of cerebral depressants, see page 231. 

THE BROMIDES 

The bromides are crystalline salts formed by the combina- 
tion of an alkali, such as potassium, sodium, ammonia, etc., 
with hydrobromic acid. This is an acid formed from bro- 
mine, an element found in sea water. 

(Every salt consists of two parts; the part derived from 
the alkali, which is called the base; and the part derived 
from the acid, which is called the acid radicle. For example, 
in potassium bromide, the potassium is the base, and is 
derived from the alkali. The bromide is the acid radicle 
and is derived from the acid. Every salt is decomposed in 
the body, into its two elements, or ions, as they are called. 
Each of these elements produces separate and different 
effects.) 

The effects of the bromide are due principally to the acid 
radicle, or bromide ion. The base of the salt also produces 
some effects. Each of the various bromides, therefore, pro- 
duces a somewhat different effect because of the different 
base with which it is combined. The most active salt of 
the bromides, is the potassium bromide. 

POTASSIUM BROMIDE 

Potassium bromide is a salt formed by the combination 
of potassium, and hydrobromic acid, or by some of their 
salts. 

371 



372 MATERIA MEDICA 

Appearance of the Patient 

About 15 to 20 minutes after an average dose of potassium 
bromide is taken, the patient complains of a dull headache, 
he feels tired and weak, and he does not care to exert him- 
self, either mentally or physically. When he moves about, 
the movements are slow and languid. He perceives objects 
about him, though not as clearly as usual, but he manifests 
no interest in them. He speaks slowly, and hesitatingly, in a 
monotonous tone of voice. He does not express his thoughts 
clearly; these are slow and confused, and his reasoning and 
memory are poor. Very often the patient becomes drowsy. 
The pulse is somewhat slower and weaker, and the breathing 
is somewhat slower. 

If the patient is nervous and excitable, he becomes calm 
and quiet. If he has tremors or convulsions, these are les- 
sened or prevented. 

ACTION 

Local action: Applied to the skin, potassium bromide pro- 
duces no effects. Mucous membranes, however, are made 
somewhat less sensitive. 

Internal Action 

In the mouth: It has a salty taste, and it makes the throat 
less sensitive; so that when it is touched, vomiting is not so 
apt to occur. 

In the stomach and intestines: No effect is produced ex- 
cept occasional nausea. 

Action after Absorption 

Potassium bromide is absorbed through the lining mem- 
brane of the stomach, in a few minutes. It is readily ab- 
sorbed, too, from all mucous membranes. After absorption, 
it affects principally the nervous system and the heart. 

Action on the nervous system: Potassium bromide lessens 
the activity of the entire nervous system; the brain, the 
spinal cord and the nerves. 

Action on the brain: The activity of the motor areas of the 



CEREBRAL DEPRESSANTS 373 

brain is lessened, so that they send out fewer impulses for 
motion. The patient then moves about slowly and lan- 
guidly; he feels weak and does not care to exert himself. 
Twitchings of the muscles and muscular contractions are 
therefore lessened. 

The activity of the speech area of the brain is lessened. The 
impulses for speech are then sent out more slowly. This 
makes the speech slow, hesitating, often indistinct and 
monotonous. 

The sensory areas of the brain are made less active. The 
patient then sees, hears, and feels objects, less distinctly. 
The impressions received by the brain through these various 
senses, are not very vivid. The patient does not then mani- 
fest much interest in the objects or activities about him. 
Since the sensory impressions are less readily received by 
the brain, consciousness is lessened, and the patient becomes 
drowsy, or even falls asleep. 

The mental activities of the brain are lessened, the memory 
is indistinct, and the reasoning is poor. Ideas do not arise 
easily. All the emotions particularly are diminished; so 
that a nervous, hysterical, emotional individual, often be- 
comes calm and quiet. This helps to produce sleep in such 
individuals, who often suffer from sleeplessness because of 
increased nervous activity. 

The headache which is often produced by bromides, is 
due to the strain that ordinary activities of the brain pro- 
duce in patients under the effect of these drugs. 

Action on the spinal cord: Potassium bromide lessens 
the activity of the spinal cord. The reflex action of the 
body is therefore lessened. The patient does not then re- 
spond readily to external stimuli applied to the skin or mu- 
cous membranes. For example, when the conjunctiva of the 
eye is touched, winking results very slowly. When the 
pharynx is touched, vomiting is not produced so easily when 
the patient is under the influence of bromides. 

The evacuation of the bladder, which is a reflex act, is 
often delayed by bromides. 

The bromides lessen the sexual activities. 

Action on the nerve endings: The sensory nerve endings 



374 MATERIA MEDICA 

become less sensitive after bromides. The patient does 
not then appreciate the various sensations clearly. 

All the above mentioned effects on the nervous system, 
are due to the bromide part of the salt, and result from any 
bromide salt, such as sodium potassium, etc. 

Action on the heart: Potassium bromide makes the heart 
beat slower and weaker, causing a slow, weak pulse. This 
effect is due to the potassium or basic part of the salt. The 
other bromides do not affect the heart. 

Action on the respiration: Potassium bromide makes the 
breathing slow and shallow. This is probably due to the 
potassium part of the salt. 

Effect on temperature: Owing to the lessened activity of 
the various organs of the body, the temperature is some- 
what lowered, because less heat is produced. 

Excretion 

The bromides are very slowly eliminated from the body, 
mainly by the kidneys, the skin (through the sweat glands), 
and by all the mucous membranes. It usually takes about 
24 to 72 hours for the bromides to be excreted, often even 
weeks and months. 

Poisonous Effects 
Acute poisoning from the bromides does not occur. Since 
they are rapidly absorbed, but very slowly excreted in some 
individuals, some of the bromides which are administered 
continually for a long time, accumulate in the body, and 
cause cumulative symptoms, chronic bromide poisoning, 
or "bromism." 

Symptoms of " Bromism " 

The symptoms may come on gradually or suddenly. They 
are due principally to the exaggerated effects of the bromides, 
and to the effects on the various tissues and organs through 
which they are excreted. For example, the rashes which 
occur, are due to the excretion of the drug through the skin. 

1. Skin eruptions. Principally pimples occurring on the 



CEREBRAL DEPRESSANTS 375 

face (acne). These may often form small abscesses. At 
other times, there are reddish spots scattered over the skin. 
The skin is usually pale and anaemic. 

2. Loss of appetite, salty taste in the mouth, bad breath, 
and disturbed digestion. 

3. Constipation. 

4. Drowsiness. 

5. Stupid, dull expression on the face. 

6. Depressed spirits, even melancholia. 

7. The eyes look heavy and dull. 

8. The patient manifests no interest in his surroundings. 

9. Slow, uncertain gait. 

10. Slow, stammering speech, often words are forgotten 
and mispronounced. 

11. Very poor memory, even recent events are forgotten. 

12. Slow pulse. 

13. Lessened reflexes, touching the conjunctiva of the 
eye does not cause winking, etc. 

Treatment 

When the bromides are stopped, these symptoms gradu- 
ally disappear. Giving cathartics and hot baths helps to 
eliminate the drug more easily. 

SODIUM BROMIDE 

Sodium bromide is a salt formed by the combination of 
sodium and hydrobromic acid, or some of their salts. It 
produces the same effects as potassium bromide, but it does 
not slow the heart and respiration, which effects are due only 
to the potassium part of potassium bromide. 

AMMONIUM BROMIDE 

Ammonium bromide is a salt formed by the combination 
of ammonia with hydrobromic acid, or by the combination 
of some of their salts. It produces the same effects as po- 
tassium bromide, but owing to the ammonium, it makes the 
pulse and breathing faster. 



376 MATERIA MEDICA 



LITHIUM BROMIDE 

Lithium bromide is a salt formed by the combination of 
lithium and hydrobromic acid, or by the combination of 
some of their salts. It is not as efficient as the other bro- 
mides. Owing to the lithium, it is more apt to upset the 
stomach, and it is said to increase the flow of urine. It is 
not so apt to cause cumulative symptoms. 

STRONTIUM BROMIDE 

This is a salt formed by the combination of strontium 
with hydrobromic acid, or by the combination of some of 
their salts. It produces the same effects as the other bro- 
mides, but it is more slowly absorbed. 

CALCIUM BROMIDE 

Calcium bromide is a salt formed by the combination of 
calcium with hydrobromic acid, or by the combination of 
some of their salts. It produces the same effects as the other 
bromides. 

DILUTE HYDROBROMIC ACID 

Dilute hydrobromic acid is a dilute solution of an acid 
formed from bromine. It produces the same effects as the 
bromides, but it is more apt to upset the stomach. 

The cumulative symptoms of bromides are the same for 
all the various bromides. 

Uses 

The bromides are used to lessen overactivity of the brain 
in the following conditions. 

1. To prevent epileptic convulsions. 

2. To relieve the muscular twitchings of chorea ("St. 
Vitus' dance"). 

3. To relieve emotionalism, nervousness or excitability in 
neurasthenia. 



CEREBRAL DEPRESSANTS 377 

4. To produce sleep when the insomnia is due to nervous- 
ness. 

5. To lessen sexual excitement. 

Preparations 
Potassium Bromide 1.0-4.0 gms. grs. xv -5i 

(Potassii Bromidum) 

Sodium Bromide 1.0-4.0 gms. grs. xv -5i 

(Sodii Bromidum) 

Ammonium Bromide 1.0-2.0 gms. grs. xv -xxx 

(Ammonii Bromidum) 

Lithium Bromide 1.0-2.0 gms. grs. xv -xxx 

(Lithii Bromidum) 

Strontium Bromide 2.0-4.0 gms. grs. xxx-5i 

(Strontii Bromidum) 

Calcium Bromide 2.0-4.0 gms. grs. xxx-3i 

(Calcii Bromidum) 

Dilute Hydrobromic Acid 2.0-12.0 gms. grs. xxx-5iii 

(Acidum Hydrobromicum Dilutum) 

This is a 10% solution of hydrobromic acid. About 7.0 
c.c. of this solution is equal to 1.0 gm. of potassium bromide. 

Monobromated Camphor 0.3-0.6 gm. grs. v-x 

(Camphora Monobromata) 

This preparation is used to lessen the excitement of hys- 
teria, neurasthenia and sexual excitement. Its effect is 
due mainly to the camphor. 

New and Non-official Preparations 
Adalin 0.3-0.6 gm. grs. v-x 

This is an organic bromide salt (brom diethyl acetylcar- 
bamide) . It produces the same effects as the other bromides. 
Brometone 0.3 gm. grs. v 

This is an organic bromide salt (acetone bromoform), 
which is said not to cause cumulative symptoms. 

Bromipin or Bromiol 1.3-10.0 gms. grs. xx-cl 

This is a combination of bromine and sesame oil. It 



378 MATERIA MEDICA, 

usually comes either in a 10 or 33}% solution. It is said 
not to cause cumulative symptoms. It is given in syrup 
flavored with peppermint water. 

Bromural 0.3-0.6 gm. grs. v-x 

This is an organic bromide salt (monobrom-isovaleryl 
urea). It is used to produce sleep in nervous patients. The 
sleep usually lasts for three to five hours. It usually comes 
in tablets, each containing 0.3 gm. (grs. v) each. 

Bromo Mangan 4.0-16.0 c.c. 5 i-iv 

This is a compound of iron, manganese, bromine and pep- 
tones. It contains about 11% of bromine. It is used to 
soothe nervousness and to build up nervous patients. 

Brovalol 0.25-0.75 gm. grs. iv-xii 

This is a compound of a valeric acid salt and bromine. 
It is used to soothe nervous patients, and is said to be more 
effectual than either the valerian preparations or the bro- 
mides alone. 

Sabromin 0.5-4.0 gms. grs. viii— 5i 

This is an organic salt formed by the combination of 
calcium and dibrombehenic acid. It produces the same 
effects as the other bromides, but they come on slower and 
last longer. It is said to have a more pleasant taste and 
not to upset the stomach. It usually comes in tablets, each 
containing 0.5 gm. (grs. viii). 

The following preparations of the bromides are occa- 
sionally used: 

Bromocoll 2.0-4.0 gms. 5-H 

This contains about 20% of bromine, gelatin and tannic 
acid. 

Bromidia 

This contains potassium bromide, chloral hydrate, extract 
of hyoscyamus, extract of cannabis indica, licorice and oil 
of orange peel. 



ANAESTHETICS 

Anaesthetics are drugs used to produce loss of sensations, 
especially to pain, so as to enable a surgical operation to be 
performed upon the patient without pain. The anaesthetics 
are divided into two classes: 

1. General Anaesthetics 

2. Local Anaesthetics 

General anaesthetics are drugs which produce a loss of 
all sensations throughout the body. No sensory impulses 
are then received by the brain, and the patient becomes un- 
conscious. 

Local anaesthetics are drugs which abolish sensations 
only on the particular area of the body where they are ap- 
plied. Since they do not abolish all sensory impulses, they 
do not produce unconsciousness. 

ETHER (AETHER) 

Ether is a colorless liquid formed by the combination of 
sulphuric acid and alcohol. It evaporates very easily, it 
is very inflammable and has a very disagreeable odor and a 
burning taste. 

Ether was first used as an anaesthetic by an American 
dentist, Dr. Morton, in 1842. 

It is usually given by inhalation through a mask or spe- 
cially constructed apparatus, to produce insensibility to pain. 
Its effects are quite similar to those of alcohol, which was 
formerly used to produce anaesthesia. Chemically, ether 
is closely related to alcohol, being formed when alcohol is 
combined with oxygen. 

Appearance of the Patient 

Ether Anaesthesia 

The most striking effect that is noticed when ether is 
given to produce anaesthesia, is that the patient struggles 
and talks a great deal. It is customary, therefore, to divide 

379 



380 MATERIA MEDICA 

the anaesthetic effects of ether, into three stages; depending 
upon whether the effects occur before the patient struggles, 
during the time of struggling, or after this stage has occurred. 
The three stages of ether anaesthesia are: 

1. The stage of imperfect consciousness, or first stage. 

2. The stage of excitement, or second stage. 

3. The stage of anaesthesia or complete unconsciousness, or 
third stage. 

Symptoms of the First Stage of Anaesthesia 

The patient has probably undergone various preparations 
for the operation, and has pictured in his mind various 
ideas of pain and suffering that the operation might produce. 
This makes him quite nervous and anxious, and his pulse 
quite rapid. He therefore regards every act of the doctor 
or nurse with suspicion. When the mask is applied to the 
face, the difficulty of obtaining air causes a choking sensa- 
tion, and the inhalation of the ether causes a burning pain 
in the throat, which often makes them cough and causes a 
profuse flow of saliva. Soon there is a feeling of warmth all 
over the body and the sensations become dulled. The sense 
of touch is blunted, objects are seen through a mist, and sounds 
appear to be at a distance. Often ringing, hissing or roaring 
sounds are heard. The muscles become stiff and the arms 
are held rigid. The face is flushed, the pupils are dilated, 
but they react to light. The pulse is rapid, and the breath- 
ing is rapid and irregular on account of the coughing and 
choking sensation. These effects last for about five or ten 
minutes and are soon followed by 

The Symptoms of the Second Stage or Excitement Stage 

This stage begins with movements of the arms. The pa- 
tient tries to push the mask away, and attempts to get up. 
Many patients struggle violently, others shout, sing, groan, 
or burst into fits of laughter. These symptoms of excitement 
seem to result from dreams which the patient seems to have. 
These dreams vary with the mode of life and the tempera- 
ment of the individual. Religiously inclined persons may 



CEREBRAL DEPRESSANTS 381 

sing hymns or pray, others become abusive, swear and fight. 
Some become jolly, laugh and sing, still others become emo- 
tional and some have fears of injury and death. 

The pulse during this stage is rapid, the skin is flushed, 
often blue, the breathing is irregular because of the strug- 
gling. These symptoms last for a few minutes, the strug- 
gling then becomes lessened, the shouting and talking be- 
come indistinct, the breathing becomes very shallow and the 
patient passes into 

The Third Stage, or the Stage of Anaesthesia 

The patient now becomes calm, quiet and unconscious. 
All sensibility is gone. The muscles are relaxed and the re- 
flexes disappear, so that when the skin is touched or injured, 
no response or movement is produced. Thus, touching the 
throat does not cause vomiting. The winking of the eye- 
lids which occurs when the eye is touched, often remains 
for some time, however. 

The pulse still remains rapid and strong, though it is slower 
than during the first and second stages. The breathing is 
deep and rapid and is often snoring in character. The pupil is 
usually contracted, and responds to fight and accommoda- 
tion. 

This stage of anaesthesia, may be kept up for hours, by 
judiciously pouring small quantities of ether on the mask. 

When the ether is stopped, the patient may again be- 
come somewhat excited and talkative, he feels nauseated 
and vomits. The patient then slowly regains conscious- 
ness, often remaining asleep for a few hours before conscious- 
ness is regained, and complains of headache and dizziness 
for hours afterward. 

ACTION 

Local action: Applied to the skin, ether evaporates so 
rapidly, that it makes the skin feel cool. It also slightly 
benumbs the sensation, acting as a mild local anaesthetic. 
On mucous membranes: It causes redness and increases 
the secretion of mucus. 



382 MATERIA MEDICA 

Internal Action 

In the mouth: It has an unpleasant burning taste, and it 
increases the flow of saliva by the reflex action produced by 
the redness of the mucous membrane which ether causes. 

In the stomach: It increases the secretions of the mucous 
membrane, and slightly checks the formation of gas (car- 
minative action). 

In the intestines: Ether causes redness and swelling of 
the mucous membrane with profuse secretion of mucus. It 
is said to destroy intestinal worms (anthelmintic action). 

Action after Absorption 

Ether is absorbed into the blood in a few minutes, through 
the mucous membranes of the lungs, stomach or intestines. 
After absorption it affects principally the brain, the heart 
and the respiration. 

Action on the brain: The effects of ether on the brain, are 
quite similar to those of alcohol. It first increases the ac- 
tivity of the brain, though lessening the self control, and 
then it lessens all its activities. 

The uncontrolled talkativeness, the constant movements, 
the dreams occurring in the excitement stage, are all evi- 
dences of increased activity of the speech, motor and imag- 
inative centers of the brain. The loss of sensibility, the 
unconsciousness and the relaxations of all the muscles which 
follow the excitement stage, and which are present during 
the stage of anaesthesia, are the result of the diminished ac- 
tivity of the sensory and motor areas of the brain. The 
unconsciousness results because the appreciation of sensa- 
tions is lessened. 

Action on the spinal cord: The reflex action, which is 
carried on mostly in the spinal cord, is at first increased, 
but soon lessened or entirely abolished by ether. Many 
reflexes, such as the reaction of the pupil to fight, the move- 
ments resulting when the sphincter is stretched, remain 
for a long time. 

Action on the respiration: Ether makes the breathing 
faster and deeper. During the excitement stage of anaes- 



CEREBRAL DEPRESSANTS 383 

thesia, however, the breathing may be irregular, because of 
the struggling, and the contractions of the muscles for 
breathing. 

Action on the lungs: It increases the secretions of the 
mucous membranes of the bronchi and lungs. 

Action on the circulation: Ether makes the heart beat 
stronger and faster. It contracts the blood vessels and in- 
creases the blood pressure. 

The characteristic pulse of ether is therefore rapid and 
strong. During the third stage of anaesthesia, the rate of 
the pulse is about normal, or a little above normal. As the 
anaesthesia progresses however, the pulse gradually be- 
comes weaker. 

Action on the blood: Ether has a tendency to destroy red 
blood corpuscles. 

Action on the muscles: All the muscles are relaxed by 
ether, when it is given as an anaesthetic. 

Action on the pupil: During the first and second stages 
of anaesthesia, the pupil is dilated because of the excite- 
ment. During the third stage, the pupils are contracted, 
but they react to light. 

Action on the kidney: Ether is somewhat injurious to 
the kidney. It often causes albumin in the urine, after a 
prolonged anaesthesia. 

Excretion 

Ether is very rapidly eliminated from the body, by the 
expired air of the lungs, usually in about a half an hour. 
When given as an anaesthetic, it is entirely excreted in 
about 24 hours; though the breath has its unpleasant odor 
during that time. 

Idiosyncrasies 

The most common variations in the effects of ether are 
the following: 

1. In some individuals, and in children, there may be no 
excitement stage. 

2. Patients who have been used to taking alcoholic liquors 



384 MATERIA MEDICA 

regularly, require larger quantities of ether to produce 
anaesthesia. These patients usually struggle a great deal. 

3. In some individuals, very small quantities may cause 
poisonous effects. 

Poisonous Effects or " Ether Collapse " 

Acute ether poisoning or ether collapse, usually results 
when too much ether is given to produce anaesthesia. 

Symptoms 

1. The first symptom which indicates that too much 
ether is being administered, is slow, shallow and gasping 
breathing. 

2. The face then becomes blue and cyanotic and the 
breathing stops. 

3. The pulse may not become affected, but it soon be- 
comes weak and irregular. 

4. The pupils are widely dilated, and do not react to light. 
The pulse gradually grows weaker, and death finally results 
from respiratory paralysis. 

Treatment 

1. Stop anaesthesia; take the mask away. 

2. Give artificial respiration. 

3. Elevate the foot of the table. 

4. Stretch the sphincter of the rectum to induce breathing 
by the reflex action thus produced. 

5. Give heart and respiratory stimulants such as caffeine, 
strychnine, atropine, etc. 

Usually, if the collapse is recognized early, these measures 
will revive the patient. 

Dangers of Ether Anaesthesia 

The following symptoms occurring during anaesthesia 
often warn the anaesthetist of impending trouble. 

1. Slow, shallow breathing. 

2. Dilated pupils which do not react to fight. 

3. Slow, weak, irregular pulse. 



CEREBRAL DEPRESSANTS 385 

4. Often the relaxed muscles of the tongue, cause the 
tongue to fall back and obstruct the breathing. 

5. In some cases, continued vomiting of the contents of 
the stomach and intestines, during deep anaesthesia, may 
cause food particles to enter the lungs and cause asphyxia. 
This can be avoided by constantly keeping the mouth 
thoroughly mopped out. 

Dangers Following Anaesthesia 

The most common condition that may occur after ether 
anaesthesia is pneumonia. This may result from the in- 
jurious effect of ether on the lungs. 

Preparations for Anaesthesia 

Before administering ether, the following measures should 
always be carried out, but the nurse must receive these 
orders from the surgeon. 

1. Move the bowels by a cathartic, about twelve hours 
before the operation, and give an enema the morning of the 
day the patient is to be operated upon. 

2. Do not give any food or drink for about twelve hours 
before the operation. This often lessens the vomiting after 
the anaesthesia. 

3. Catheterize the patient before the operation. 

4. Remove all false teeth, so that the patient will not swal- 
low them during the anaesthesia. 

5. When the anaesthesia is begun, the eyes should be 
covered with a piece of gauze, and the face protected with 
vaseline to avoid the injurious effects of the ether fumes. 

Administration 

To produce anaesthesia, ether is given by inhalation 
through a mask held over the nose and mouth, in the follow- 
ing ways. 

The Open Method or Drop Method 

The ether is poured drop by drop on a mask covered with 
gauze, and the patient is then allowed to inhale the ether 



386 MATERIA MEDICA 

vapor which is thoroughly mixed with air. This is the 
most common method of administration now in use. 

The Closed Mask Method 

This method is gradually being abandoned. The ether is 
given through a cone saturated with ether, but it is mixed 
with very little air. 

There are numerous apparatus for giving ether, many of 
which have various advantages, such as warming the vapor, 
etc. 

Gas Ether Method 

This is a very common method now in vogue, whereby 
the patient is first given nitrous oxide gas, and then ether. 
In this way, many of the unpleasant effects of ether, and the 
excitement stage, are avoided. 

Ether is also occasionally given as an anaesthetic by the 
rectum, by means of a specially constructed apparatus. 

Recently, a method has been devised for producing anaes- 
thesia by giving ether intravenously. The ether is given in 
an intravenous infusion of salt solution. 

In giving an anaesthetic, it is important that the drug be 
administered very slowly, and the breathing and pulse 
should be watched very carefully throughout the anaes- 
thesia. In this way, the serious dangers are avoided. 

Uses 

Beside its use as an anaesthetic, ether is used 

1. As a heart stimulant. 

2. To check convulsions. 

3. As a carminative, to lessen the formation of gas in 
the stomach and intestines. 

Preparations 
Ether 0.5-1.0 c.c. m. viii-xv 

(Aether) 

This contains 96% of ether, and is used principally as an 
anaesthetic. The dose of ether for anaesthesia varies with 
the patient, and the degree of anaesthesia desired. 

Spirits of Ether 2.0-4.0 c.c. 3i -i 

(Spiritus Aetheris) 



CEREBRAL DEPRESSANTS 387 

This consists of 32 parts of ether and 68 parts of alcohol. 

Compound Spirits of Ether 2.0-4.0 c.c. 3^-1 

(Spiritus Aetheris Compositus) 
(Hoffman's Anodyne) 

This contains 32% of ether, alcohol and other substances 
known as ethereal oils. It is used principally to check the 
formation of gas in the stomach and intestines, and as a 
remedy for fainting. It is usually diluted with cold or iced 
water. 

Spirits of Nitrous Ether 1.0-4.0 c.c. m. xv~5i 

(Spiritus Aetheris Nitrosi) 
(Sweet Spirit of Niter) 

This preparation is used to increase the perspiration and 
the flow of urine, but it also causes the same stimulating 
effects as ether. 

CHLOROFORM 

Chloroform is a colorless non-inflammable fluid, which 
evaporates easily, but not as rapidly as ether. It is formed 
by the combination of alcohol with chlorine. Chemically, 
it is a compound of methane (marsh gas) with chlorine 
forming trichlor methane or chloroform. It is used princi- 
pally as an anaesthetic. 

Chloroform Anaesthesia 

When chloroform is given as an anaesthetic, the symptoms 
it produces can be divided into three stages as in ether anaes- 
thesia. 

During the first stage, the patient is nervous, anxious, 
and his sensations are dulled, but the anaesthetic is more 
pleasant to take than ether. The pulse is usually rapid. 

Very soon, the second stage sets in, the excitement, talka- 
tiveness and struggling, however, are usually much less, and 
last for a shorter time than with ether. This stage is very 
often entirely absent. 

The stage of anaesthesia, or third stage, comes on very 
rapidly with chloroform. The patient is calm, quiet and 
unconscious. The breathing is slow and shallow, the rate of 



388 MATERIA MEDICA 

the pulse is normal, perhaps somewhat slower but weak. The 
face is pale, and the pupils are contracted, but they react 
to light. All sensibility and reflex action are gone, and the 
muscles are relaxed. 

With chloroform, anaesthesia is induced much quicker 
than with ether, usually in about five or ten minutes. The 
muscles become relaxed sooner, the pulse is weak and slower 
and the breathing is shallow. 

ACTION 

Local action: Applied to the skin, the sensibility is some- 
what lessened by chloroform, and it causes redness and a 
burning sensation. If it is prevented from evaporating, it 
may form a blister. On mucous membranes: It causes red- 
ness and increases the secretion. 

Internal Action 

In the mouth: It has a hot sweetish taste and it increases 
the flow of saliva. 

In the stomach: It causes a feeling of warmth and checks 
the formation of gas (carminative action). It increases the 
secretion of the mucous membranes of the stomach and the 
peristalsis. 

In the intestines: If given in large doses, the secretions 
and peristalsis of the intestines are both increased. 

Action after Absorption 

Chloroform is absorbed into the blood through the mucous 
membrane of the stomach in about fifteen minutes; when 
given by mouth. When inhaled as an anaesthetic, it enters 
the blood from the mucous membrane of the lungs still more 
rapidly. It is also readily absorbed through all the mucous 
membranes. After absorption it affects principally the 
brain, the heart and the respiration. 

Action on the brain: Chloroform produces the same ef- 
fects on the brain as ether does. It increases its activity 
at first, but soon lessens it. The result of this action, is a 
preliminary stage of excitement and talkativeness, followed 



CEREBRAL DEPRESSANTS 389 

by unconsciousness, loss of sensation and relaxation of the 
muscles. 

Action on the spinal cord: Chloroform at first increases, 
and then lessens the reflex action throughout the body. 

Action on the respiration: It makes the breathing slower 
and shallower. 

Action on the lungs: Chloroform does not increase the 
secretion of the lungs as much as ether does. 

Action on the circulation: Chloroform makes the heart beat 
slower and weaker, by weakening the contractions of the 
heart muscle. It widens the blood vessels and lowers the 
blood pressure. The chloroform pulse is slow and weak. 

Action on the blood: Chloroform has a tendency to de- 
stroy red blood corpuscles. 

Action on the pupil: The pupil is contracted, but it re- 
acts to light and accommodation. 

Action on the muscles: Chloroform relaxes all the muscles 
of the body. 

Action on the kidney: It is distinctly injurious to the 
kidney, and changes some of the constituents of the kidney 
cells to fat. It often causes albumin in the urine. 

Excretion 

Chloroform is rapidly eliminated, mainly by the expired 
air of the lungs; though some of it is also excreted by the 
urine and the perspiration. 

Poisonous Effects 

Chloroform poisoning occurs in two forms: 

1. Acute Chloroform Poisoning 

2. Delayed Chloroform Poisoning 

Acute Chloroform Poisoning 

Acute chloroform poisoning usually results when too much 
chloroform is given as an anaesthetic; or in susceptible in- 
dividuals, from very small quantities; even as little as a 
few drops. 



390 MATERIA MEDICA 

Sudden Chloroform Death 

Sudden death occasionally occurs from chloroform, in 
susceptible individuals, even when only a few drops are 
administered for anaesthesia. 

This occurs usually during the first stage of anaesthesia. 
The pulse becomes very slow and weak, the face turns pale, the 
breathing becomes very shallow and slow, the pupils are widely 
dilated, and the patient dies in a few minutes. 

This very unfortunate occurrence, is the result of the 
coughing and burning pains in the throat which occur dur- 
ing the first stage of anaesthesia. Impulses are thus sent 
to the Vagus center in the medulla, which then sends im- 
pulses to the heart to make it beat slower. (Reflex action.) 

Such impulses usually cause fainting, which is a condi- 
tion where the heart stops beating for a few moments, but 
soon recovers again. In sudden chloroform death, however, 
the heart muscle is poisoned by the chloroform; so that it 
does not contract again, after it has suddenly stopped beat- 
ing, and death results. 

If atropine is given before chloroform anaesthesia, it 
occasionally acts as a safeguard against this dreaded acci- 
dent. The atropine paralyzes the nerve endings of the Vagus 
nerve in the heart, and prevents impulses to slow the heart 
contractions, from reaching it. 

When this accident occurs, it is usually treated by giving 
atropine and other heart stimulants hypodermically, and 
massaging the chest over the heart. Every now and then 
the patient recovers after vigorous treatment. 

Symptoms of Chloroform Collapse 

When too much chloroform is given during anaesthesia, 
the following symptoms usually result, in the order of their 
onset. 

1. The pulse becomes slow, weak and irregular, usually 
about 50 or 40 to the minute. 

2. Slow and shallow breathing. 

3. Face is pale. 

4. The pupils are widely dilated, and do not react to light 
or accommodation. 



CEREBRAL DEPRESSANTS 391 

5. The pulse and breathing become still slower, and the 
patient dies from paralysis of the heart. 

Treatment 

1. Stop the anaesthesia, and take the mask away as soon 
as the slow and weak character of the pulse is noticed. 

2. Give heart stimulants such as atropine, caffeine, 
strychnine, etc. 

3. Give artificial respiration. 

4. Elevate the foot of the table. 

Delayed Chloroform Poisoning 

This form of chloroform poisoning occurs occasionally, 
and the symptoms appear about a few days after the anaes- 
thetic has been administered. It is due to the destruction 
of many of the cells of the liver, kidney, and heart, which 
then become filled up with fat globules. (Fatty degenera- 
tion.) 

Symptoms 

1. Nausea and vomiting, the vomited matter containing 
bile. 

2. Jaundice. 

3. Delirium. 

4. Convulsions. 

5. Scanty urine, which contains albumin, and two sub- 
stances characteristic of this condition, leucin and tyrosin. 

6. Collapse (slow, weak pulse, slow, shallow breathing, 
etc.). 

The patient usually dies in a few days from profound 
collapse. 

Administration 

Chloroform is usually given by inhalation, by means of 
a mask covered with gauze, which is held over the patient's 
nose and mouth. A few drops of chloroform are poured 
on the mask and allowed to mix thoroughly with air. Dan- 
gers of chloroform are best avoided, by pouring the chloro- 
form very slowly, a drop at a time, and allowing the vapor 
to thoroughly mix with air. 



392 MATERIA MEDICA 

The nurse is often called upon to give chloroform during 
labor, in obstetrical cases. Very little chloroform should 
then be given, as it is necessary in such cases, to administer 
the chloroform only when the patient has severe pains. Com- 
plete anaesthesia is not desired in these cases, as the uterine 
contractions are then lessened, and the birth of the child is 
thus retarded. The pulse and breathing should be watched 
very carefully throughout the anaesthesia. 

Uses 

Beside its use as an anaesthetic, chloroform is given : 

1. To stop convulsions (by inhalation). 

2. To check diarrhoea and to lessen colic (by internal ad- 
ministration). 

3. Chloroform liniment is frequently used as a local ap- 
plication to relieve pain. 

Preparations 

For Internal Use: 

Chloroform 0.06-1.0 c.c. m. i-xv 

(Chloroformum) 

The dose of chloroform for anaesthesia, varies with the 
patient, and the degree of anaesthesia desired. 

Chloroform should always be kept in brown bottles, as it 
readily decomposes into dangerous substances, by the action 
of light. 

Spirits of Chloroform 2.0-4.0 c.c. m. xxx-5 i 

(Spiritus Chloroform!) 

This contains 10% of chloroform. 

Emulsion of Chloroform 15.0-30.0 c.c. %\-i 

(Emulsum Chloroformi) 

This contains 4% of chloroform. 

Chlorodyne 0.3-2.0 c.c. m. v-xxx 

(Not official) 

This contains chloroform, ether, hydrocyanic acid, mor- 
phine and cannabis indica. 



CEREBRAL DEPRESSANTS 393 

For Local Use: 
Chloroform Liniment 
(Linimentum Chloroformi) 

This consists of soap liniment and chloroform, and con- 
tains 30% of chloroform. 

Compound Chloroform Liniment (not official) 
(Linimentum Chloroformi Compositus) 

This contains chloroform, oil of turpentine, laudanum, 
tincture of aconite, and soap liniment. 

COMPARATIVE ACTION OF ETHER AND CHLOROFORM 

ETHER CHLOROFORM 

1. Inflammable 1. Not inflammable 

2. Cools the skin 2. Burns the skin 

3. Unpleasant to take 3. More pleasant to take 

4. Anaesthesia induced with 4. Deeper anaesthesia induced 

larger quantities, and with smaller quantities, 

not as deep. 

5. Marked excitement stage 5. Little or no excitement stage 

6. Pulse rapid and strong 6. Pulse slow and weak 

7. Skin bright red in color 7. Skin pale 

8. Suitable in cases where the 8. Suitable in cases where the 

heart action is weak or lungs are diseased or in 

where the kidneys are drunkards. 

diseased. 

Dangers 

9. Respiratory collapse 9. Cardiac collapse 

After Effects 

10. More vomiting 10. Less vomiting 

11. Apt to cause pneumonia 11. Apt to cause delayed chloro- 

form poisoning 

ETHYL BROMIDE (AETHYLIC BROMIDUM) (not official) 

Ethyl bromide or bromide of ether, is a colorless liquid 
which evaporates easily. It has a disagreeable, sweetish 
taste, and an ethereal odor. 



394 MATERIA MEDICA 

ACTION 

Ethyl bromide is used to produce anaesthesia, especially 
for short operations, or to begin an ether anaesthesia. Its 
effects are similar to those of chloroform, and it has the 
same weakening action on the heart. When its administra- 
tion is stopped, consciousness returns very quickly, and 
the patient feels quite weak. It is usually given as a con- 
centrated vapor, mixed with very little air. 

It should be kept in brown bottles, as it is decomposed very 
easily by the action of light, forming dangerous substances. 

ETHYL CHLORIDE (AETHYLIC CHLORIDUM) 

Ethyl chloride, chloride of ether or kelene, is formed by 
the action of hydrochloric acid gas on alcohol. It evaporates 
very easily. It usually comes in special glass containers, 
with a long, pointed end, which is broken off or unscrewed. 
A fine stream of vapor then shoots out, which is directed on 
the skin or on the mask. 

ACTION 

Local action: Because it evaporates very easily, ethyl 
chloride freezes the skin over which it is applied, producing 
local anaesthesia of the part. Minor surgical operations 
can be performed under this local anaesthesia. It should 
be applied until the tissues become white and hard, when 
it should be stopped; if it is continued after this, it is apt 
to injure the tissues. 

General Action 

Ethyl bromide is also used as a general anaesthetic. It 
produces anaesthesia very rapidly, usually in about 1 to 5 
minutes. 

Its effects are similar to those of chloroform, but it does 
not cause complete muscular relaxation. The pulse is slow 
and weak, and the breathing is deep. The patient usually 
recovers from the effects very rapidly. It is usually given 
to begin anaesthesia, and it is not suitable for prolonged 
use, because it weakens the heart even more than chloro- 
form and it does not cause complete muscular relaxation. 



CEREBRAL DEPRESSANTS 395 



PENTAL 

Pental is a colorless liquid made from fusel oil. Chemically 
it is trimethylethylene. 

It has been used to produce anaesthesia for short opera- 
tions, and it produces no after effects. Its effects are similar 
to those of ether or chloroform, but it does not cause much 
muscular relaxation. It has no effect on the heart or respira- 
tion. It occasionally causes twitchings of the muscles, or 
convulsions, even during anaesthesia. 

METHYLENE BICHLORIDE (not official) 

Methylene bichloride is an inflammable, colorless fluid 
which has an odor like chloroform. Its effects are similar 
to those of chloroform. It produces rapid anaesthesia which 
soon wears off. It slows and weakens the heart action. 

ANAESTHETIC MIXTURES 

The following preparations are mixtures of various anaes- 
thetics. They are said to have various advantages over a 
single anaesthetic. 



This consists of 



A. C. E. MIXTURE 

Alcohol i 

Ether 2 Parts by volume 

Chloroform 3 

ANAESTHOL 

This is a mixture of 

Chloroform 36% 
Ether 47% 

Ethyl Chloride 17% 

This mixture is said to have the same boiling point as 
the blood, and therefore to be easily excreted. The dangers 
of chloroform are thus said to be avoided. 

When these mixtures are given, the ether and the ethyl 
chloride evaporate more quickly than the chloroform. 



396 MATERIA MEDICA 

The anaesthetist is then giving concentrated chloroform, 
instead of a diluted mixture. Dangerous symptoms are 
thus more apt to follow, especially in warm weather, since 
the ether and other ingredients evaporate more easily than 
the chloroform. 

SOMNOFORM 

This is a mixture of 

Ethyl Chloride 65% 
Ethyl Bromide 5% 
Methyl Chloride 30% 

NITROUS OXIDE GAS (LAUGHING GAS) 

Nitrous oxide gas is a colorless gas without any odor. It 
is made by distilling ammonium nitrate. The gas is passed 
through water, and collected in small metal cylinders, in 
which it usually comes for practical use. It is the safest 
and most pleasant anaesthetic known. 

Appearance of the Patient 
Nitrous Oxide Anaesthesia 

A few seconds after inhaling nitrous oxide gas, the patient 
usually feels rushing, drumming or hammering noises in the 
ears, the sight becomes indistinct, and he has a feeling of 
warmth and comfort all over the body. The arms and legs 
move constantly about, the patient is bright, lively, very jolly, 
and bursts out into fits of laughter (hence the name "laughing 
gas"). These symptoms last for about 2 or 3 minutes and 
then the patient feels drowsy, falls asleep, and loses all sen- 
sibility. 

During the anaesthesia, the face is dark red in color, often 
blue, the breathing is deep and snoring in character, the pulse 
is slow, strong and tense, and the blood pressure is very high. 
If the nitrous oxide is judiciously mixed with air, the anaes- 
thesia can be kept up for a half to one hour. 

As soon as the mask is taken away, however, the patient 
becomes conscious in about 1 to 3 minutes, and has no after 
effects, except perhaps a slight headache, which may persist 
for a few hours. 



CEREBRAL DEPRESSANTS 397 

Nitrous oxide does not relax the muscles, so that pro- 
longed abdominal operations cannot be performed under 
its anaesthesia. 

ACTION 

Nitrous oxide is a gas which is only given by inhalation to 
produce anaesthesia. It is absorbed into the blood from the 
lungs almost immediately. The symptoms which it pro- 
duces are due to its action on the brain, the blood and respira- 
tion. 

Action on the brain: The noises in the ears, the move- 
ments of the extremities, the laughter, are all evidences of 
increased activity of the brain. These symptoms last for a 
few minutes and are almost immediately followed by symp- 
toms of lessened brain activity; such as sleep and loss of 
sensation. 

Action on the respiration: Nitrous oxide gas, by taking 
the place of oxygen in the lungs and in the blood, prevents 
the haemoglobin from obtaining its necessary oxygen. The 
patient then suffers from asphyxia. This makes the breath- 
ing deep and snoring in character (stertorous), and the blood 
becomes blue in color so that the face has a purple or blue 
color during anaesthesia. 

Action on the heart: The slow, strong pulse and high 
blood pressure are the result of the asphyxia, and are not 
due to any effect on the heart or blood vessels. 

Excretion 

Nitrous oxide gas is eliminated from the body in a few 
minutes by the expired air. 

Poisonous Effects 

When too much nitrous oxide is given, the following 
symptoms are produced, because the haemoglobin is unable 
to obtain its necessary oxygen. The blood is then impure 
and is poisonous to the brain and other organs of the body. 

Symptoms 
1. The face is blue in color. 



398 MATERIA MEDICA 

2. The breathing is difficult and deep. 

3. Slow, strong pulse, with very high blood pressure. 

4. Convulsions. 

These symptoms disappear as soon as the nitrous oxide is 
stopped. 

Administration 

Nitrous oxide gas is usually given by inhalation, by means 
of a specially constructed apparatus, consisting of a mask 
attached to a large rubber bag, which is filled with the gas 
from a metal container. 

Uses 

Nitrous oxide gas is used to produce anaesthesia for short 
surgical operations, and to begin ether anaesthesia, so as 
to avoid its unpleasant symptoms and excitement stage. 

LOCAL ANAESTHETICS 

The following drugs are used to produce insensibility to 
pain, or anaesthesia, only on the tissues over which they 
are applied. Drugs which produce such an effect, are called 
local anaesthetics. 

Many of the local anaesthetics are applied directly to the 
surface of the skin or mucous membranes, while others are 
injected underneath the skin (hypodermically). 

LOCAL ANAESTHETICS USED BY DIRECT APPLICATION 

ETHER 

Ether is rarely used as a local anaesthetic, as its local 
effects last only for a very short time. It cools the skin by 
rapidly evaporating, and makes it insensible to pain. 

ETHYL CHLORIDE 

Ethyl chloride is most commonly used as a local anaes- 
thetic. It is usually sprayed on the skin, by means of a 
special glass container. It freezes the area over which it is 
sprayed by its very rapid evaporation, thereby producing 



CEREBRAL DEPRESSANTS 399 

local anaesthesia. The spraying should be stopped when the 
skin becomes white and hard, as it may injure the tissues 
if continued further. 



MENTHOL 

Menthol is a camphor-like substance (stearoptene) ob- 
tained from the oil of peppermint. It produces a feeling 
of coolness on the skin and mucous membranes, and pro- 
duces local anaesthesia. The anaesthesia is not sufficiently 
marked, however, to enable a surgical operation to be 
performed. It is used principally to relieve painful conditions 
of the skin. 



Guiacol 

Tincture of Aconite 

Veratine 



also cause local anaesthesia, but are 
rarely used for this purpose. 



LOCAL ANAESTHETICS GIVEN PRINCIPALLY BY 
HYPODERMIC INJECTION 

COCAINE 

Cocaine is the best drug for local anaesthesia. It is readily 
absorbed into the blood, however, and may then cause poi- 
sonous symptoms. To avoid these, it should be remem- 
bered, that the total amount of any solution of cocaine to 
be injected, must not contain more than 0.03 gm. (gr. i) of 
cocaine hydrochloride, which is its maximum dose. 

As a local anaesthetic, cocaine is given in the following 
ways: 

1. On mucous membranes, such as the nose, throat or 
larynx, it is applied with a cotton applicator. A 10 or 20% 
solution is used for this purpose. 

Occasionally a few drops of a solution of cocaine crystals 
dissolved in adrenalin, are used. This contracts the blood 
vessels very markedly and prevents the absorption of the co- 
caine and at the same time produces a maximum anaes- 
thetic effect. 

2. Infiltration anaesthesia. This is a method of inject- 



400 MATERIA MEDICA 

ing cocaine in very weak solutions; such as a 1-1000 to \% 
solution. For large areas, large quantities of weaker solu- 
tions may be used. For small areas, stronger solutions such 
as 4% may be used. To avoid poisonous effects, the cocaine 
is often injected together with adrenalin chloride solutions. 
There are numerous preparations made up in this way. The 
most common of these are 

Braun's Solution 

This consists of 

Cocaine hydrochloride 0.5-0.1 

Sodium chloride 10.0-100.0 

Adrenalin chloride solution 0.3-0.6 

Schleich's Solution 

This is made by dissolving 3 tablets, each of which con- 
tains 

Cocaine hydrochloride 0.03 

Morphine hydrochloride 0.008 

Sodium chloride 0.06 

in 100 c.c. of water. 
Cocaine absorption is often prevented by tying a tight 
bandage around the part to be anaesthetized, so as to con- 
tract its blood vessels. 

3. Cocaine is also occasionally injected into the nerve 
leading from the part to be operated upon. This lessens 
the sensibility of the area from which the nerve fibers come. 

EUCAINE 

Eucaine is an artificial alkaloid which is used as a local 
anaesthetic. It produces local anaesthesia like cocaine. 
It differs from cocaine, however, in the following ways. 

1. It does not contract the blood vessels. 

2. It slows and weakens the contractions of the heart, by 
directly affecting the heart muscle, thereby causing a slow, 
weak pulse, with low blood pressure. 

3. It does not dilate the pupil. 



CEREBRAL DEPRESSANTS 401 

Administration 

For local anaesthesia in the eye, it is used in a \% solu- 
tion. On other mucous membranes, it is applied in 2-10% 
solutions. 

For infiltration anaesthesia, it is used in a 1-500 to 1% 
solution. 

Eucaine is not as poisonous as cocaine, and it can be boiled. 

It is also often used in the form of an ointment for painful 
haemorrhoids. 

Preparations 

Eucaine is called beta eucaine, to distinguish it from alpha 
eucaine which was formerly used as a local anaesthetic, 
but because of dangerous symptoms which it produces, it 
has now been given up. 

Beta Eucaine Hydrochloride 
(Beta Eucaine Hydrochloridum) 

Beta Eucaine Lactate 
(Beta Eucainae Lactas) 

This is more soluble than the hydrochloride. 

TROPACOCAINE 

Tropacocaine is an alkaloid obtained from the leaves of 
the coca plant of Java. It is usually made artificially, how- 
ever. 

ACTION 

Tropacocaine is used principally to produce local anaes- 
thesia. Its effects are similar to those of cocaine, but they 
come on sooner, and last longer than with cocaine. It does 
not dilate the pupil as much as cocaine. 

Preparations 

Tropacocaine Hydrochloride 0.03-0.06 gm. gr. \-\ 
(Tropacocainae Hydrochloridum) 

It is used principally in 3-10% solutions. 



402 MATERIA MEDICA 

HOLOCAIN 

Holocain is an artificial alkaloid made from phenacetin. 
Its effects are similar to those of cocaine, but they appear 
sooner. It is also an antiseptic. It occasionally causes poi- 
sonous symptoms. 

Preparations 

Holocain Hydrochloride 
(Holocainae Hydrochloridum) 

It is principally used in a 1% solution as a local anaes- 
thetic in the eye. 

NOVOCAINE 

Novocaine is an artificial alkaloid which is used as a local 
anaesthetic. It acts like cocaine, but it is less poisonous 
and its effects wear off quickly. It is usually given together 
with adrenalin. 

Preparations 
Novocaine Tablets Each tablet contains 0.02-0.2 gm. grs. J-iii 

There are also tablets containing novocaine and adrenalin. 

Novocaine Nitrate 0.02-0.2 gm. grs. J-iii 

(Novocainae Nitras) 

It is usually used in a 3% solution. 

ALYPIN 

Alypin is an artificial alkaloid which is used as a local 
anaesthetic. It is supposed not to produce poisonous symp- 
toms. 

It is used principally as a local anaesthetic for eye opera- 
tions, and in the urethra and bladder, before passing instru- 
ments into these organs. 

In the eye it is used in 1-2% solutions. On other mucous 
membranes, it is used in 1-10% solutions. 

Preparations 
Alypin Tablets Each tablet contains 0.02-0.2 gm. grs. J-iii 



CEREBRAL DEPRESSANTS 403 



STOVAINE 

Stovaine is an artificial alkaloid which is used principally 
as a local anaesthetic and for spinal anaesthesia. Its effects 
are similar to those of cocaine with the following differences: 

1. It dilates the blood vessels. 

2. It is less poisonous than cocaine. 

In the eye it is used in a 4% solution. On other mucous 
membranes, in a 5-10% solution. Hypodermically, it is 
used in a i-1% solution. 

Preparations 
Stovaine (in pills) each containing 0.002 gm. gr. -gV- 

ORTHOFORM 

Orthoform is an artificial chemical substance formed by 
the combination of methyl alcohol and amidoxybenzoic acid 
(such a combination of an alcohol and an acid is called an 
ester). 

It is used as a local anaesthetic like cocaine, but since it is 
very slowly absorbed, it produces no general effects and no 
poisonous symptoms. It is not used hypodermically. It 
is used principally to relieve pain on a wounded surface and 
on mucous membranes. It is often used to relieve the pain 
of an ulcer in the stomach. 

Preparations 

Orthoform New 0.5-1.0 gm. grs. viii-xv 

It is often applied on wounds in the form of a dusting 
powder or as an ointment. 

ANAESTHESIN 

Anaesthesin is a chemical substance used as a local anaes- 
thetic. It is an ester of alcohol and paramidobenzoic acid. 

ACTION 

The effects of anaesthesin are similar to those of cocaine. 



404 MATERIA MEDICA 

It produces local anaesthesia, but no general effects, as it 
does not dissolve readily and is not absorbed. 

It is used internally to relieve the pain of ulcers in the 
stomach or of cancer of the stomach. It is also applied to 
relieve pain on the mucous membrane of the nose, throat, 
urethra, etc., and on wounded surfaces. 

Preparations 
Anaesthesin 0.3-0.5 gm. grs. v-viii 

It is also used in the form of a powder or an ointment. 

Cycloform 0.1-0.2 gm. grs. ii-iii 

It produces the same effects as anaesthesin, but is some- 
what antiseptic. 

Propaesin 0.25-0.5 gm. grs. iv-viii 

This acts like anaesthesin and it also contracts the mucous 
membrane. It is often used in 1-20% ointments. 

SPINAL ANAESTHESIA 

Anaesthesia is often produced by injecting a solution of 
one of the local anaesthetics into the spinal canal. The 
solution is very slowly injected by means of a hypodermic 
syringe with a specially constructed needle which is inserted 
into the spinal canal between two of the vertebrae. This 
produces anaesthesia in about 15 to 20 minutes over the 
entire surface of the body below the level of the point of 
injection. The effect produced is due to the action of the 
drug on the nerve trunks which enter the spinal cord. 

The drugs principally used for this purpose are cocaine, 
tropacocaine, and stovaine. Dangerous symptoms and 
even death may result from this method of anaesthesia. 



HYPNOTICS 

Hypnotics, soporifics, narcotics, or somnifacients, are 
drugs which lessen the activity of the brain, thereby pro- 
ducing sleep, or unconsciousness. 

Their effects are similar to those produced by the general 
anaesthetics, but they are milder and more lasting. 

The hypnotics are usually given by the mouth, and are 
slowly absorbed, their effects lasting for several hours. 

Mode of Action 

Our consciousness depends upon the impulses received 
from our surroundings through the various senses. Hyp- 
notics, by lessening the activity of the brain, lessen also 
the activity of its sensory areas, so that fewer impulses are 
received from our environments, and unconsciousness or 
sleep results. 

When the activity of the sensory areas is lessened, the 
appreciation of pain, one of the sensations, is also lessened; 
so that many of the hypnotics relieve pain (Anodyne action) 
as well as produce sleep. 

The most efficient drug used as a hypnotic is chloral. 

CHLORAL 

Chloral is an oily, colorless liquid made by the combina- 
tion of chlorine gas with absolute alcohol. It is not used in 
medicine, but when it is combined with water, it forms 
crystals of chloral hydrate, which is the preparation or- 
dinarily used. 

Appearance of the Patient 

About 5 to 15 minutes after an average dose of chloral 
hydrate is given, the patient feels tired and drowsy, and 
soon falls asleep. The sleep lasts for about five to eight 
hours. It resembles the natural sleep, and the patient can 
be easily awakened; by pain, loud sounds, or when touched. 
During the sleep, the pulse and breathing are slow, and 
the pupils are contracted. 

405 



406 MATERIA MEDICA 

When the patient awakes, he may complain of a little 
headache and dizziness, and may be a little confused. 

ACTION 

Local action: Applied to the skin, chloral causes redness 
and even blisters. It also has an antiseptic action, checking 
the growth of bacteria. On mucous membranes it causes 
redness and increases the secretions. 

Internal Action 

In the mouth it has a hot, burning taste. 
In the stomach and intestines : It increases the secretions. 
It occasionally causes nausea and vomiting. 

Action after Absorption 

Chloral is very rapidly absorbed into the blood through 
the mucous membrane of the stomach; usually in about 5 to 
15 minutes. After absorption, it affects principally the brain, 
the heart, and respiration. 

Action on the brain: Chloral lessens the activity of the 
brain. The sensory areas of the brain are particularly af- 
fected; so that the brain does not appreciate the impulses 
received through the various senses, and unconsciousness 
or sleep then results. Very intense sensations, such as pain, 
are appreciated, however, and these may even prevent 
sleep. Chloral also lessens the motor activities of the brain. 

Action on the spinal cord: The reflex actions of the spinal 
cord are lessened by chloral. External stimuli therefore 
produce little response. 

Action on the heart: Chloral makes the heart beat slower 
and weaker by weakening the contractions of the heart mus- 
cle. The pulse then becomes slower and weaker. 

Action on the respiration: The breathing becomes some- 
what slower and shallower, because fewer impulses for breath- 
ing are sent out from the respiratory center in the medulla. 

Effect on the temperature: Chloral lowers the temperature 
several degrees by lessening the muscular movements; so 
that less heat is produced. 



CEREBRAL DEPRESSANTS 407 

Excretion 

Chloral is eliminated from the body mainly by the kid- 
neys in about several hours, as urochloralic acid. 

Idiosyncrasies 

Chloral often causes the following unusual effects: 

1. Redness and swelling of the conjunctiva of the eye. 

2. Flushed face and neck. 

3. Eruptions of large, red areas of skin, which are often 
distinctly raised above the surface (wheals). The eruptions 
often peel (desquamate). 

4. Dyspnoea. 

5. Rise of temperature. 

Dangerous Symptoms 

Chloral Collapse 

In giving chloral, the patient must be carefully watched, 

and the pulse should be taken very frequently, as sudden 

heart failure from chloral is not at all uncommon, even from 

a single dose. 

Symptoms 

1. Restlessness. 

2. Slow, weak pulse, about 50 to 40 to the minute. 

3. Slow, shallow breathing. 

4. Coma. 

The chloral should be stopped when these symptoms dis- 
appear. 

The danger is usually over when the pulse is above 60 and 
is regular and strong. 

Tolerance 

If chloral is taken habitually, the patient becomes accus- 
tomed to the drug, so that large doses may be taken with- 
out producing any poisonous effects. 

Poisonous Effects 

Acute chloral poisoning is a condition which occasionally 
results from the administration of an overdose of chloral in 
alcohol (" knockout drops"). The same symptoms occur 
when an overdose of chloral is given medicinally. 



408 MATERIA MEDICA 

Symptoms 

1. Very deep sleep from which the patient is aroused with 
difficulty. (Stupor.) 

2. Very slow and shallow breathing. 

3. Slow, weak, irregular pulse with low blood pressure. 

4. Insensibility to pain. 

5. Contracted pupils. 

With larger amounts, these symptoms are followed by: 

1. Coma (deep sleep from which the patient cannot be 
awakened). 

2. Relaxation of the muscles. 

3. Very rapid, thready and irregular pulse. 

4. Dilated pupils. 

Death usually results from paralysis of the heart and 
breathing. The smallest fatal dose is 2.0 gms. (grs. xxx). 

Treatment 

1. Wash out the stomach. 

2. Give artificial respiration. 

3. Keep the patient warm. 

4. Give atropine, caffeine, strong coffee, or alcohol ; to in- 
crease the action of the heart and respiration. 

Chloral Habit 

Habitual use of chloral often causes symptoms resembling 
those of the opium habit or chronic alcoholism. It changes 
into fat globules, many of the constituents of the cells of 
the various organs of the body, such as the liver and kidney. 
The following symptoms usually result from this condition. 

1. The patient feels melancholic and "blue." 

2. Wakefulness and nervousness at night. 

3. Loss of appetite and disturbed digestion. 

4. Various eruptions on the body. 

If the drug is suddenly stopped, symptoms resembling 
delirium tremens result. To relieve these symptoms, the 
patient must be gradually weaned of the habit. 

Uses 
Chloral is used principally: 



CEREBRAL DEPRESSANTS 409 

1. To produce sleep. 

2. To lessen the excitement of delirium tremens and other 
similar conditions. 

3. To prevent the convulsions of strychnine poisoning, 
epilepsy, uraemia, etc. 

Administration 

Chloral hydrate is best given only slightly diluted in 
syrup, about 15 minutes to a half hour before bedtime. 

Preparations 

Chloral Hydrate 0.6-2.0 gms. grs. x-xxx 

(Chloralum Hydratum) 

Croton Chloral Hydrate 0.3-1.3 gm. grs. v-xx 

or 
Butyl Chloral Hydrate 

This resembles chloral in its effects; it is not as efficient 
but the effects are more lasting. It lessens particularly, the 
sensations carried from the face by branches of the fifth 
cranial nerve. It is therefore frequently used to relieve the 
intense pain of trifacial neuralgia ("tic douleureux.") 

Metachloral (not official) 

This is a substance made by the action of sulphuric acid 
on chloral. It is used as a local anaesthetic. 

Bromal Hydrate (not official) 0.12-0.3 gm. grs. ii-v 

This substance is formed by the action of bromine on 
alcohol. It acts like chloral, but is more dangerous. 

Chloral Camphor: This consists of equal parts of chloral 
and camphor and is used as a local application to relieve 
pain. 

CHLORALFORMAMID 

Chloralformamid is a white, crystalline powder with a 
slightly bitter taste. It is a chemical compound of chloral. 

It produces sleep, and its effects are similar to those of 
chloral. It does not weaken the heart action, but it is not 
as reliable as chloral. 



410 MATERIA MEDICA 

Preparations 
Chloralformamid 1.0-2.0 gms. grs. xv-xxx 

It is usually given in powder form dissolved in whiskey. 

CHLORALOSE (not official) 

Chloralose is a white, crystalline powder having a bitter 
taste. It is a compound of chloral and glucose (grape-sugar). 

It produces sleep; its effects are similar to those of 
chloral, but it is not as reliable. 

Preparations 
Chloralose 0.3-0.6 gm. grs. v-x 

PARALDEHYDE 

Paraldehyde is a colorless liquid having a peculiar, un- 
pleasant taste and odor. It is an oxidation product of 
alcohol. 

Appearance of the Patient 

A few minutes after an average dose of paraldehyde is 
given, the patient becomes drowsy and soon falls asleep. 
The sleep resembles the natural sleep, and lasts from about 
5 to 6 hours, but it is not as deep as after chloral. The pulse 
and breathing are normal, and there are usually no after 
effects when the patient awakes. 

ACTION 

The action of paraldehyde is similar to that of chloral. 

Local action: Applied to the skin, it causes redness, pain, and 
occasionally forms blisters. On mucous membranes: It causes 
redness and increases the secretions. 

Internal Action 

In the mouth: Paraldehyde has a hot, burning taste. 
In the stomach and intestines: It increases the secretions; 
it often causes nausea and occasionally vomiting. 

Action after Absorption 
Paraldehyde is absorbed into the blood in a few minutes, 



CEREBRAL DEPRESSANTS 411 

through the mucous membrane of the stomach. After ab- 
sorption, it acts principally on the nervous system. 

Action on the brain: Paraldehyde lessens all the activi- 
ties of the brain. It lessens the appreciation of all sensory 
impulses, thereby producing sleep. Intense sensations, such 
as pain, can still be appreciated, however, and these may keep 
the patient awake. 

The motor activities of the brain are also lessened, and the 
muscles are relaxed during sleep. 

Action on the spinal cord: Paraldehyde lessens all the 
activities of the spinal cord. All reflex action is lessened, 
so that the patient does not respond readily to external 
stimuli. 

Action on the heart and respiration: Paraldehyde does 
not affect the heart action, and in the doses that it is usually 
given, it does not affect the breathing. 

Effect on the temperature: Paraldehyde lowers the tem- 
perature by lessening the production of heat. 

Excretion 
Paraldehyde is excreted in the urine in a few hours. It 
is also eliminated by the expired air of the lungs. The 
breath often has the unpleasant odor of paraldehyde for a 
long time after it is given. 

Poisonous Effects 
Paraldehyde rarely, if ever, causes fatal symptoms. Over- 
doses often cause the following symptoms: 

1. Vomiting. 

2. Stupor. 

3. Slow, shallow breathing. 

4. Cyanosis. 

If given continually, it occasionally causes: 

1. Nausea, loss of appetite, and poor digestion. 

2. Ulcers in the nose. 

3. Various eruptions, principally areas of redness. (Ery- 
thema.) 

Uses 

Paraldehyde is used principally to produce sleep, and to 
lessen muscular activity in epilepsy and delirium tremens. 



412 MATERIA MEDICA 

Administration 

In giving paraldehyde, it is important to disguise its taste, 
otherwise many patients cannot take it. It should be well 
diluted in water or brandy, or it may be given in syrup. 
It should be given a few minutes before bedtime. 

Paraldehyde is frequently given by the rectum, especially 
in cases of delirium tremens. 

Preparations 

Paraldehyde 1.0-4.0 gms. grs. xv-5 i 

(Paraldehydum) 

SULPHONAL 

Sulphonal or sulphonmethanum, is a white powder hav- 
ing no odor or taste. It does not dissolve readily in water. 
Chemically, it is a compound of sulphur and alcohol. 

Appearance of the Patient 

Within 1 to 6 hours after giving a dose of sulphonal, the 
patient falls asleep. The sleep is not very deep, but it lasts 
from about 8 to 10 hours, and sometimes longer. The 
pulse and breathing are usually not affected. On awakening, 
the patient often feels drowsy, complains of fullness in the 
head, and headache, and his gait may be a little unsteady. 
Occasionally, sulphonal is so slowly absorbed that it produces 
sleep the day following its administration. 

ACTION 

Sulphonal resembles chloral in its effects, which come on 
much slower, however. Sulphonal produces no local effects. 

Internal Action 

No effects are produced by sulphonal in the mouth, stomach, 
or intestines. 

Action after Absorption 

Sulphonal is very slowly absorbed into the blood from the 
stomach, usually in about 1 to 6 hours. After absorption, 
it affects principally the brain. 



CEREBRAL DEPRESSANTS 413 

Action on the brain: It lessens the activity of the brain, 
producing sleep. 

Action on the respiration: In large doses, sulphonal often 
makes the breathing slow and shallow. 

It does not affect the heart action. 

Excretion 

Sulphonal is eliminated very slowly by the urine, as 
ethylsulphonic acid. Since it is excreted more slowly than 
it is absorbed, it often causes cumulative symptoms. 

Idiosyncrasies 

In some individuals, instead of sleep, the following symp- 
toms are produced. 

1. Nausea and vomiting. 

2. Excitement. 

3. Dizziness. 

4. Staggering. 

Poisonous Effects 

Acute Sulphonal Poisoning 

An overdose of sulphonal is rarely, if ever, fatal. It oc- 
casionally causes the following symptoms: 

1. Stupor. 

2. Slow, shallow breathing. 

Cumulative Symptoms or Chronic Sulphonal Poisoning 

Since sulphonal is more slowly excreted than it is absorbed, 
its prolonged use often causes the following alarming symp- 
toms, which may even result in death. 

1. Pink color of the urine, due to haematoporphyrin, a 
substance which is formed in the urine by the decomposition 
of the haemoglobin of the blood. 

2. Abdominal pain. 

3. Nausea and vomiting. 

4. Constipation. 

5. Weakness and unsteady gait. 

6. Paralysis of various groups of muscles of the arms or 
legs. 



414 MATERIA MEDICA 

7. Suppressed urine; the urine often containing albumin. 

8. Collapse, which may result in death. 

Treatment 

1. Stop the drug. 

2. Give saline diuretics. 

3. Move the bowels thoroughly. 

4. Treat the collapse with heart stimulants. 

Administration 

Sulphonal is best given in milk or hot water several hours 
before bedtime. When given in this way, it acts more 
readily and is not so apt to cause unpleasant after effects. 
It is also given in the form of a powder. 

Preparations 

Sulphonal 1.0-2.0 gm. grs. xv-xxx 

(Sulphonmethanum) 

TRIONAL 

Trional, or sulphonethylmethanum, is a powder having a 
bitter taste. It is an artificial chemical substance. 

Appearance of the Patient 

An average dose of trional usually produces natural sleep 
in about 15 minutes to an hour after it is given. The sleep 
lasts several hours and is accompanied by slight headache. 

ACTION 

The effects of trional are the same as those of sulphonal. 
It is more readily absorbed, however, and it does not affect 
the heart or respiration. It occasionally causes the same 
chronic poisonous symptoms as sulphonal. 

Administration 

Trional should be given about a half to one hour before 
bedtime in large quantities, with hot milk or beer. 



CEREBRAL DEPRESSANTS 415 

Preparations 

Trional 1.0-2.0 gms. grs. xv-xxx 

(Sulphonethylmethanum) 

TETRONAL (not official) 

Tetronal is a white powder. Its effects are similar to those 
of trional and sulphonal. It is given in the same way, but 
it is not often used because it is more poisonous. 

Tetronal 1.0-2.0 gms. grs. xv-xxx 

URETHANE (ETHYX CARBAMATE) 

Urethane or ethyl carbamate is a colorless, crystalline 
powder with a salty taste. It is an artificial chemical sub- 
stance. 

ACTION 

Urethane produces sleep in about 15 to 20 minutes, the 
sleep lasting for about 6 to 8 hours. 

Its effects are similar to those of paraldehyde, but it is 
not as reliable. 

It does not upset the stomach, however, and because it is 
readily dissolved, it may be given hypodermically. 

Preparations 

Urethane 1.0-4.0 gms. grs. xv-5 i 

(Aethylis Carbamas) 

BROMOFORM 

Bromoform is a heavy colorless liquid with an odor and 
taste like that of chloroform. 

ACTION 

Bromoform acts like chloral, but its effects appear much 
slower. Its principal effects are : 

1. It produces sleep. 

2. It relieves pain. 

3. It lessens spasmodic contractions of the muscles. 

4. It is an antiseptic. 



416 MATERIA MEDICA 

It is principally used to relieve the spasmodic cough of 
whooping cough. 

Bromoform 0.2 c.c. m. iii 

AMYLENE HYDRATE (not official) 

Amylene hydrate is a colorless liquid, having an odor 
resembling that of camphor, and a pungent taste. 

ACTION 

It produces sleep; its effects are similar to those of chloral. 
They are not as marked. It weakens the contractions of 
the heart and lessens all muscular contractions. 

It is best given in capsules or in water, flavored with 
licorice. 

Preparations 

Amylene Hydrate 2.0-4.0 c.c. m. xxx-5i 

(Amyleni Hydras) 

HYPNONE (not official) 

Hypnone is a colorless liquid formed from alcohol. It 
has a characteristic odor like that of oranges. It produces 
sleep but it is not very efficient. 

Hypnone 0.3-0.6 c.c. m. v-xv 

NEW AND NON-OFFICIAL HYPNOTICS 
VERONAL 

Veronal, or diethyl barbituric acid, is a white crystalline 
powder, which has a slightly bitter taste. It is an artificial 
chemical substance. 

Appearance of the Patient 

About fifteen minutes to a half an hour after an average 
dose of veronal is given, the patient usually falls asleep. 
The sleep resembles the normal sleep, and lasts for five to 
six hours. On awakening, the patient often complains 
of headache and dizziness. Occasionally, some patients 
have peculiar vivid dreams during the sleep. The pulse 



CEREBRAL DEPRESSANTS 417 

and breathing are not usually affected by veronal. It is a 
very safe drug. 

Administration 

Veronal is usually given in hot milk, about fifteen minutes 
to a half an hour before bedtime. 

Preparations 

Veronal 0.3-1.0 gm. grs. v-xv 

(Veronalum) 

Diethyl Barbituric Acid 

It usually comes in tablets each containing 0.3 gm. 
(grs. v) each. 

Veronal Sodium 0.3 gm. grs. v 

(Sodium Diethyl Barbiturate) 

This is a sodium salt of veronal. It usually comes in 
tablets each containing 0.3 gm. (grs. v). It produces the 
same effects as veronal, but since it is more readily dissolved, 
it produces sleep more rapidly, and it can be given hypo- 
dermically or by rectum. 

Medinal 0.3 gm. grs. v 

This is a proprietary name for sodium veronal. It usually 
comes in tablets. 

Medinal Suppositories 

Each suppository contains 0.5 gm. (grs. viii). 

CHLORETONE 

Chloretone is a white crystalline powder which has an 
odor like camphor and does not readily dissolve in water. 

ACTION 
Local action: Applied to the skin, it acts as an antiseptic. 

Internal Action 

When it is taken internally, it soothes the stomach, and 
is rapidly absorbed into the blood by the mucous membrane. 



418 MATERIA MEDICA 

After absorption, it acts principally on the brain. It lessens 
the activity of the brain, producing sleep. It also lessens 
the motor activities of the brain, so that fewer impulses for 
motion are sent out from the brain, and it lessens muscular 
contractions. It can produce general anaesthesia, but it is 
rarely used for this effect. 

Uses 

Chloretone is used to produce sleep, and very frequently 
to check an epileptic attack, and to lessen other convulsions 
such as those occurring in tetanus, etc. It is occasionally 
used to check vomiting and seasickness. 

Preparations 
Chloretone 0.3-1.0 gm. grs. v-xv 

It is also used in a 1% solution. 

HEDONAL 

Hedonal is a white crystalline powder with a cooling 
taste, like that of menthol. 

It produces sleep in about half an hour after it is given. 
It is a safe drug and produces no after effects. It occasion- 
ally increases the flow of urine. 

Preparations 
Hedonal 2.0 gms. grs. xxx 

It is given in powder or in tablets. 

ISOPRAL 

Isopral is a white crystalline substance, with an aromatic 
taste and an odor resembling camphor. 

It produces sleep in about five minutes after it is given. 
Its effects are similar to those of chloral, but it is not as 
poisonous. It is said to be absorbed through the skin. 

Preparations 
Isopral 0.2-0.5 gm. grs. iii-viii 



CEREBRAL DEPRESSANTS 419 

NEURONAL 

Neuronal is a white crystalline substance having a bitter 
taste and odor resembling menthol. It produces sleep. 
Its effects resemble those of veronal, and it is given in the 
same way. 

Neuronal 0.3-2.0 gms. grs. v-xxx 

DORMIOL (AMYLENE CHLORAL) 

Dormiol or amylene chloral, is a colorless oily fluid with 
an odor like that of camphor. It is a compound of amylene 
hydrate and chloral. It produces sleep in about half an 
hour after it is given, with no after effects and it does not 
weaken the heart action. It is given principally to insane 
patients. 

Preparations 

Amylene Chloral 1.0-4.0 c.c. m. xv-3i 

Acetal 4.0-8.0 gm. 3i-ii 

Methylal 

These are chemical substances formed from alcohol, 
which are occasionally used to soothe the patient and to 
produce sleep. They act like sulphonal. 

PELLOTINE HYDROCHLORIDE 0.015-0.6 gm. grs. H 

This is an alkaloid from a Mexican plant used to produce 
sleep. 

MORPHINE AND OPIUM 

Morphine and opium produce sleep when the patient is 
unable to sleep on account of pain. Their effects will be 
more fully described under their more important actions. 

BROMIDES 

Bromides produce sleep when the patient is unable to 
sleep on account of nervousness. 



TABLE OF COMPARATIVE ACTION OF HYPNOTICS 



Name of 
Drug 


Action on 
Stomach 


Rate of 
Absorption 


Action on 
the Heart 


Action on 
the Res- 
piration 


After 
Effects 


Poison- 
ous 
Symp- 
toms 


Chloral. 


Occasional 
nausea. 


Rapid. 


Slow and 
weak. 


Slow and 
shallow. 


Occasional 
headache 
and dizzi- 
ness. 


Weak 
heart 

action. 

Sudden 
heart 

failure. 


Chloralamid. 


Same. 


Same. 


Not as 
weak. 


Not so 
slow. 


Same. 


Safer 

than 

chloral. 


Paraldehyde. 


Very un- 
pleasant 
taste. 


Same. 


No effect. 


No effect. 


No after 
effects. 


Not poi- 
sonous. 


Sulphonal. 


No effect. 


Very slow. 


Same. 


Same. 


Headache, 
drowsi- 
ness. 

Fullness in 
the head. 


Cumu- 
lative 
effects. 


Trional. 


Same. 


Slow. 


Same. 


Same. 


Slight 
headache. 


Not poi- 
sonous. 


Veronal. 


Same. 


Moder- 
ately rapid. 


Same. 


Same. 


Slight 

headache, 

occasional 

dreams. 


Not poi- 
sonous. 


Medinal 

(can be given 
hypodermic- 
ally). 


Same. 


Rapid. 


Same. 


Same. 


Same. 


Same. 


Chloretone 
(it lessens 
muscular con- 
tractions) . 


Soothing. 


Rapid. 


Same. 


Same. 


No after 
effects. 


Same. 


Urethane 
(can be given 
hypodermic- 
ally). 


Same. 


Same. 


Same. 


Same. 


Same. 


Same. 


Amylene 
Hydrate. 


Occasional 
nausea. 


Moder- 
ately rapid. 


Slow and 
weak. 


Slow and 
shallow. 


Same. 


Same. 


Hedonal 

(diuretic) . 


No effect. 


Same. 


No effect. 


No effect. 


Same. 


No 

effect. 


Isopral. 


Same. 


Same. 


Same. 


Same. 


Same. 


Same. 


Neuronal. 


Same. 


Same. 


Same. 


Same. 


Same. 


Same. 


Dormiol 

used on insane 
patients. 


Same. 


Same. 


Same. 


Same. 


Same. 


Same. 



420 



ANODYNES 

Anodynes are drugs which are used principally to relieve 
pain. Pain can be relieved in several ways. 

1. By lessening the activity of the sensory areas of the 
brain so that the impulses of pain which the brain receives, 
are not appreciated. 

2. By lessening the activity of the nerve endings in the 
skin which receive the impulses of pain. 

Anodynes are divided into two classes: 

1. General Anodynes 

2. Local Anodynes 

General anodynes relieve pain when given internally. 

Local anodynes relieve pain when applied only to the 
particular tissue where the pain is felt. 

Only the general anodynes will be considered here. The 
most important drug of this group is opium, and its alkaloid 
morphine. The local anodynes will be considered under 
their appropriate local effects. 



OPIUM AND MORPHINE 

Opium is the hardened dried juice of the unripe capsules 
of the Papaver somniferum or white poppy, a plant which 
grows principally in Turkey, Asia Minor, Persia, India and 
China. The drug is obtained by making a longitudinal cut 
in the side of the capsule, when a thick white milky juice 
oozes out. This is exposed to the air, and allowed to dry. 
It then turns brown and hard, and is wrapped up in the 
leaves of the plant. This dried juice with a peculiar char- 
acteristic odor is the crude opium, from which all the prepara- 
tions are made. 

Opium is one of the oldest drugs in medicine. It is the 
most reliable and most useful drug in our entire Materia 
Medica. It relieves better than anything else, the suffering 
and pain caused by any disease. 

421 



422 MATERIA MEDICA 

Active Principles 

Opium produces its effects by means of a large number of 
active principles which it contains. They are all alkaloids. 
The most important of these are: 

Morphine 

Papaverine 

Codeine 

Narcotine 

Thebaine 

The action of opium is due principally to the morphine 
which it contains, usually amounting to 9% of the drug. 
Morphine affects principally the brain, while the other alka- 
loids each successively affects the brain less, and the medulla 
and spinal cord more, so that thebaine produces effects 
similar to that of strychnine, which are due principally to 
the action on the spinal cord, and very little to its action on 
the brain. 

Appearance of the Patient 

About ten to fifteen minutes after giving an average dose 
of opium or morphine, the patient complains less of the pain 
from which he may have been suffering. He becomes calm 
and quiet, and feels comfortable. He usually lies in a 
quiet dreamy state, his mind filled with vivid images and 
brilliant ideas. When spoken to, he does not pay attention, 
because his mind is preoccupied with continual vivid dreams, 
in which the patient seems to see various objects and persons 
about him, and he seems to be in various places. These 
dreams cause so much pleasure, that the patient forgets; 
everything — pain, cares, worries, even the idea of time seems 
to be shortened for him. 

Soon however, the patient falls into a light sleep from 
which he can be easily aroused. During the sleep, he usually 
has vivid dreams, many of which he often remembers after- 
wards. Often the sleep resembles the natural sleep. The 
breathing is slow and shallow, the pulse is perhaps some- 
what slower, the face is flushed, the pupils are contracted 
and the skin may be moist. These effects last for several 
hours, and gradually wear off, leaving the patient feeling 



CEREBRAL DEPRESSANTS 423 

dull and depressed, with dryness of the throat and occasion- 
ally a slight headache and nausea. 

ACTION 

Local action: Applied to the unbroken skin, opium slightly 
relieves pain by paralyzing the sensory nerve endings. On 
wounded surfaces or ulcers: It contracts and hardens the 
tissues (astringent action). 

Mucous membranes are contracted, and their secretions 
checked by opium. Opium is readily absorbed from wounded 
surfaces and mucous membranes when locally applied to 
them. 

Internal Action 

In the mouth: It checks the secretions and contracts the 
mucous membrane, causing a feeling of dryness. 

In the stomach: It checks the secretion of gastric juice 
and lessens the peristalsis. The food is therefore more 
slowly digested. It also lessens the appetite and the feeling 
of hunger. Later, however, opium or morphine increases the 
secretions in the stomach and may even cause nausea and 
vomiting. 

In the intestines : The secretions of the mucous membrane 
and the peristaltic contractions of its muscle wall are les- 
sened. Constipation then results. 

Action after Absorption 

Opium or morphine is very slowly absorbed into the blood 
through the mucous membrane of the stomach, usually in 
about ten to fifteen minutes. When given hypodermically, 
it is absorbed in about two to five minutes. After absorp- 
tion, it affects principally the brain, the respiration, the 
secretory glands and the pupil. 

Action on the Nervous System 

On the brain: Opium or morphine lessens all the activities 
of the brain except the imagination, which is made more 
active. 

On the sensory areas: It lessens the activities of all the 
sensory areas of the brain. x Thus, the appreciation of all 



424 MATERIA MEDICA 

sensory impulses, especially that of pain, is lessened. Since 
consciousness is the result of the sensory impressions received 
through our sensations, by lessening these, opium or mor- 
phine produces unconsciousness or sleep. When the patient is 
unable to sleep on account of pain, these drugs are particu- 
larly valuable. The sleep is light, however, and the patient 
may be easily awakened. Often it is deeper and resembles 
the natural sleep. 

On the motor areas: The action of the motor areas of the 
brain is slightly lessened, so that the patient is not quite so 
active. 

On the mental activities: The higher mental activities 
of the brain, such as will power, judgment, reasoning, and 
concentration are all lessened, so that the intelligence is 
lessened. 

The action of the imaginative center of the brain, however, 
is greatly increased. The patient is then able to combine 
all old impressions that have been stored up in the brain, 
more readily and more rapidly into new ones. The resulting 
thoughts then flow more freely. 

Vivid dreams therefore occur continually, during the sleep 
of opium or morphine. Even when the patient is awake, but 
under the influence of the drug, he may be absorbed in va- 
rious thoughts and dreams which he may conjure up before 
his mind. These give the patient a feeling of pleasure and 
comfort, and absorb his thoughts so that he forgets every- 
thing — pain, worries, cares, even the idea of time. It is be- 
cause of these pleasant effects, that opium tends to form a 
habit, if given continually. The patient may even have 
brilliant ideas under the effect of this drug, but because of 
the lessened will power which it produces, he is unable to 
carry these ideas into effect. 

The increased activity of the imagination is more marked 
in more educated, and higher intellectual types of individuals. 
Some of the best literary works in the world have been 
written while the author was under the influence of opium, 
when his imagination was very active. 

Action on the respiration: Opium or morphine makes the 
breathing slower and shallower by lessening the impulses for 



CEREBRAL DEPRESSANTS 425 

breathing, that are sent out from the respiratory center in 
the medulla. 

Action on the circulation: It produces no effect on the 
heart. 

The blood vessels of the face and neck are widened, how- 
ever, causing a flushed face and a feeling of warmth. 

The pulse after opium or morphine, is usually a normal 
strong pulse. With larger doses, the pulse is somewhat 
slower but stronger. 

This is due to the slow breathing which prevents the blood 
from getting the proper amount of oxygen, and the character 
of the pulse is the result of the slight asphyxia which then 
occurs. 

Action on the secretory glands: Opium or morphine checks 
all the secretions except the sweat, which it increases. 

The flow of saliva, of bile, of the secretions of the mucous 
membranes of the stomach and intestines are all lessened. 
The secretion of urine is often markedly diminished. 

The perspiration is increased more by the preparations 
of opium than by those of morphine. 

Action on the involuntary muscles: The contractions of the 
involuntary muscles are lessened. Intestinal peristalsis is 
thus lessened, which, in addition to the checked secretion of 
the intestines, causes constipation. 

Action on the pupil: Opium or morphine contracts the 
pupil. It makes the pupil very small when given internally. 
When applied locally to the conjunctiva it produces no 
effects. 

Excretion 

Opium or morphine, is rapidly eliminated from the body 
mainly by the digestive tract; into the stomach, intestines 
and saliva, usually in about an hour. The excretion of the 
drug into the stomach often increases its secretions, and 
causes nausea and vomiting. Often the drug is absorbed 
again from the stomach. It is also slightly excreted by the 
urine. 

Summary of Effects 

The most important effects of opium or morphine are the 
following: 



426 MATERIA MEDICA 

1. It relieves pain. 

2. It makes the breathing slower. 

3. It lessens all the secretions, except the sweat; which is 
increased. 

4. It checks peristalsis, producing constipation. 

5. It contracts the pupil. 

Idiosyncrasies 

a. Idiosyncrasies of Effect. 

In some individuals, the following unusual effects occasion- 
ally occur: 

1. Weakness and depression. 

2. Continual nausea and vomiting. 

3. Delirium and excitement. 

4. Convulsions. 

5. Redness of the skin and itching while the effects are 
passing off. 

6. Absence of urinary secretion, especially in cases of 
nephritis. 

b. Idiosyncrasies of Dose 

In some individuals a very small dose may cause very deep 
sleep, and even poisonous effects. In others, a very large 
dose may cause no effects at all, or only slight effects. Old 
people and children are very susceptible to opium or mor- 
phine. They may get poisonous symptoms from very small 
quantities. 

Poisonous Effects 

Poisoning from opium or morphine occurs in two forms, 
acute opium poisoning and chronic opium poisoning or 
opium habit. 

Acute Opium Poisoning 

Acute opium poisoning usually results from an overdose 
given medicinally, or taken with suicidal intent. 

Symptoms 
Since the most striking effect of opium is sleep, the symp- 
toms are divided into three stages, depending on whether 



CEREBRAL DEPRESSANTS 427 

the patient can be aroused from the sleep, whether he can 
be aroused with difficulty (stupor) or whether he cannot be 
aroused at all (coma). 

Symptoms of the First Stage 

1. Very deep sleep, from which the patient can be aroused, 
but soon falls asleep again. 

2. Slow, shallow breathing. 

3. Slow, strong pulse. 

4. Flushed face. 

5. Contracted pupils. 

6. Profuse perspiration. 

If a very large dose has been taken, these symptoms 
may last for a very short time, or they may be absent 
entirely, and are soon followed by 

The Second Stage or Stage of Stupor 

1. The sleep is very deep, and the patient can be aroused 
only with great difficulty. If spoken to in a loud voice, or 
when he is shaken and his attention attracted, he may re- 
main awake for a few minutes; but he soon falls asleep 
again. 

2. The breathing is very slow and shallow, about 8 to 10 
times a minute. It often becomes periodic ; a few moments 
of breathing alternating with periods of absent breathing 
(Cheyne Stoke's Respiration). 

3. The pulse is slow and strong. 

4. The pupils are contracted and are very small. 

5. The face is pale or it may be blue; because the blood 
does not get enough oxygen on account of the slow and 
shallow breathing. 

6. The skin is covered with perspiration. 

These symptoms last for a short time, and the patient soon 
passes into 

The Third Stage or Stage of Coma 

1. The patient now lies in a very deep sleep, from which he 
cannot be aroused. 



428 MATERIA MEDICA 

2. The breathing is very slow and shallow, about 3 to 4 times 
a minute. 

3. The pulse is rapid and weak. 

4. The face is blue in color (cyanosis). 

5. The pupils are very small, so that they can hardly be 
seen. They are often called " pin-point pupils," because of 
their extremely small size. 

6. Skin is cold and moist. 

The breathing finally becomes still slower, the pupils 
dilate, and the patient dies from paralysis of the respiration, 
though the heart may beat for several minutes afterwards. 

Synopsis of Poisonous Effects 

The characteristic symptoms of acute opium or morphine 
poisoning are: 

1. Very deep sleep, stupor, followed by coma. 

2. Slow and shallow breathing. 

3. Slow pulse. 

4. Contracted pupils "pin-point pupils." 

5. Cyanosis. 

6. Profuse perspiration. 

Treatment 

1. Wash out the stomach, with plain water, or better still, 
with a 1-5000 potassium permanganate solution. This 
destroys the drug. The washing should be repeated every 
half hour until the patient is entirely out of danger. Even 
if the drug is given hypodermically, the stomach should be 
washed out, as the drug is excreted into the stomach, and 
repeated washings help to get rid of it. 

2. If the stomach cannot be washed out, for lack of 
apparatus, etc., or if a solid preparation has been taken, 
emetics should be given repeatedly, about every 15 minutes. 

A tablespoonful of mustard in a glass of water, zinc sul- 
phate 0.6-2.0 gms. (grs. x-xxx) or copper sulphate 0.3-0.6 
gm. (grs. v-x) may be given to produce vomiting. 

Give also potassium permanganate to destroy the drug. 

3. Give atropine, gr. T fo- This is the antidote for mor- 
phine. It should be repeated every 15 minutes or half 



CEREBRAL DEPRESSANTS 429 

hour until the breathing becomes deep and fast. Atropine 
should never be given without the doctor's orders, as atro- 
pine poisoning may result from its injudicious use, and more 
harm done. 

4. Keep the patient awake by applying cold douches 
on the skin, by rubbing or striking him with cold towels. 
This increases the breathing and keeps the patient awake; 
and, while the patient is awake, the breathing is increased. 
Care must be taken, however, not to exhaust the patient by 
too violent measures. 

5. Keep up artificial respiration continuously. 

6. Give respiratory stimulants, such as caffeine, or a hot 
coffee enema, strychnine, etc. 

7. Apply the farradic current to the Vagus nerve in the 
neck. 

8. Keep the patient warm. 

9. Catheterize the bladder. 

Artificial respiration may also be given by a new method, 
by means of pumping air into the lungs through a catheter 
inserted into the trachea. The air is pumped into the lungs 
by means of a specially constructed apparatus used for giv- 
ing anaesthesia in this way. (Meltzer Auer method.) 

The treatment of opium poisoning should be kept up for 
hours, as long as the patient is alive. Patients have recov- 
ered from as much as 2.0 gms. (grs. xxx) of morphine, by 
persistent treatment. 

Chronic Opium Poisoning or Opium Habit 

The opium habit results occasionally in patients to whom 
it has been necessary to give opium or morphine for a long 
period of time. The pleasant effects which opium causes, 
often induce the habit. It is usually taken in the form of 
opium pills, laudanum, or by hypodermic injections of 
morphine. In China and India, the crude opium is smoked 
by many people. Opium habitues may take as much as 
300 grs. of opium without causing dangerous symptoms. 

Symptoms 
The patient usually has a great craving for the drug, princi- 



430 MATERIA MEDICA 

pally because it helps him to forget everything — cares, wor- 
ries, troubles, even the idea of time. He looks dull and 
dreamy, his mind is occupied with various images and ideas, 
and he has absolutely no will power. He lacks all sense of 
honor and truth. The untruthfulness of the opium habitue is 
proverbial. Thus, pills of opium, or a hypodermic syringe 
and morphine tablets may be found under his pillow, and 
yet he will deny all knowledge of them. 

The patient is very nervous, he has no energy and he can 
do no work, except when he is under the influence of the 
drug. His gait is unsteady, he has tremors of the muscles, 
he is very anaemic and loses weight. The pulse is often 
irregular and the pupils are contracted. He has no appetite, 
his bowels are constipated, though there are periods when he 
has profuse diarrhoea. 

The patients often have abscesses on the extremities, from 
lack of care in taking hypodermic injections. 

In some patients, melancholia and various forms of in- 
sanity occur from continued use of the drug. In others, no 
serious results may follow. 

If the drug is suddenly stopped, the most intense misery 
is produced, and the patients are in a most pitiable state, 
for want of the drug. 

An average dose of opium or morphine usually does not 
produce sleep in opium habitues. 

Treatment 

The opium habit is best treated in special sanatoria for 
that purpose. The drug should be stopped gradually, and 
the patients should be very carefully watched, as they will 
use the most ingenious methods to obtain the drug through 
their friends, through the mails, etc. 

Uses 

Opium or morphine is used for a great many conditions. 
In fact, there is hardly a condition or disease in which this 
drug is not useful. It is used principally: 

1. To relieve pain. For this purpose it is the best and 
most reliable drug in our entire Materia Medica. 



CEREBRAL DEPRESSANTS 431 

2. To produce sleep, especially when the patient is unable 
to sleep on account of pain. 

3. To lessen peristalsis and produce constipation. 

4. To check the secretions, except the sweat. 

5. To lessen all forms of nervous excitement, such as 
delirium tremens, convulsions, tetanus, etc. 

Administration 

For rapid effects, morphine, given hvpodermically, is 
the best preparation to use. Opium is better where con- 
stipation is desired. 





Preparations 








Opium 








Solid Preparations 






Powdered Opium 
(Opii Pulvis) 


0.03-0.12 gm. 


grs. 


Hi 


This contains 12% 


of morphine. 






Deodorized Opium 
(Opii Deodoratum) 


0.03-0.12 gm. 


grs. 


Hi 


This contains 12% of morphine, but its odorous substances 
have been removed. 


Pills of Opium 


1 pill 







(Pilulae Opii) 

Each pill contains 0.06 gm. (gr. i) of powdered opium. 
These pills must be freshly made, as otherwise they accumu- 
late in the stomach and cause poisonous effects. 

Extract of Opium 0.015-0.06 gm. gr. H 

(Extractum Opii) 

This contains 20% of morphine. 

Powder of Ipecac and Opium 0.6 gm. grs. x 

(Pulvis Ipecacuauhae et Opii) 
(Dover's powder) 

Each powder contains 0.06 gm. (gr. i) each of ipecac 
and opium, and 0. 5 gm. (grs. viii) of milk sugar (it contains 
10% of opium). Dover's powder is taken at night in hot 



432 MATERIA MEDICA 

lemonade to break up a cold. It increases the perspiration 
very freely. 

Troches of Licorice and Opium 
(Trochisci Glycyrrhizae et Opii) 

(Wistar's cough lozenges) 

Each lozenge contains gr. i of opium. It is used to lessen 
cough. 

For Local Use 
Opium Plaster 
(Emplastrum Opii) 

This contains 6% of opium. 

Liquid Preparations 

Tincture of Opium 0.3-1.0 c.c. m. v-xv 

(Tinctura Opii) 

(Laudanum) 

This contains 10% of opium. 

Tincture of Deodorized Opium 0.3-1.0 c.c. m. v-xv 
(Tinctura Opii Deodorata) 

(McMunn's elixir) 

This contains 10% of opium. It contains no narcotine, 
and no odorous principals, and is therefore more pleasant 
to take. 

Camphorated Tincture of Opium 
(Tinctura Opii Camphorata) 

(Paregoric) For Adult 

4.0-16.0 c.c. 5i-iv 

For Children 
Under 1 year 0.06-0.3 c.c. 
" 2 years 0.3 -1.0 c.c. 
" 3 " 0.3 -1.3 c.c. 
" 5 " 0.3 -1.6 c.c. 
" 10 " 1.0 -2.0 c.c. 

Paregoric contains 0.12 gm. (grs. ii) of opium to 30.0 gms. 
or (5 i) together with camphor, benzoic acid, oil of anise 
and glycerine. It is the best preparation of opium to use 
for children. 



m. 


l-V 


m. 


v-xv 


m. 


v-xx 


m. 


v-xxv 


m. 


xv-xxx 



CEREBRAL DEPRESSANTS 433 

Tincture of Ipecac and Opium 0.3-1.0 c.c. m. v-xv 
(Tinctura Ipecacuanhae et Opii) 

(Tincture of Dover's powder) 

This contains 10% of opium. 

Wine of Opium 0.3-1.0 c.c. m. v-xv 

(Vinum Opii) 

This is flavored with cinnamon and cloves. 

Acetum Opii 0.3-1.0 c.c. m. v-xv 

(Black drop) 

This is opium extract with dilute acetic acid. 

Mistura Glycyrrhizae Com- 

posita 15.0-30.0 c.c. S f-i 

(Brown's mixture) 

This contains 1 part of opium in 1000 of the mixture. 
It consists of paregoric, licorice, wine of antimony, and 
spirits of nitrous ether. It is used to lessen cough. 

Compound Tincture of Opium 4.0 c.c. 5 i 

(Tinctura Opii Composita) 

(Squibb's diarrhoea mixture) 

This contains tincture of opium, tincture of capsicum, 
spirits of camphor, chloroform and alcohol. 

ALKALOIDS OF OPIUM 
Morphine 
The effects of opium are due principally to the morphine 
which it contains. 

The effects of morphine differ slightly from those of opium 
in the following ways: 

1. Morphine is much more rapidly absorbed, and therefore 
acts more rapidly. 

2. It can be given hypodermically. 

3. It does not increase the secretion of sweat as much as 
opium. 

4. It is not as constipating as opium. 

Preparations 
Morphine 0.008-0.03 gm. gr. -J-J 

(Morphina) 



434 MATERIA MEDICA 

Morphine Sulphate 0.008-0.03 gm. gr. |-| 

(Morphinae Sulphas) 

Morphine Hydrochloride 0.008-0.03 gm. gr. f-J 

(Morphinae Hydrochloridum) 

Compound Morphine Powder 0.3 -1.0 gm. grs. v-xv 
(Pulvis Morphinae Compositus) 
(Tully's powder) 

This contains morphine sulphate, licorice powder, and 
camphor. 

Magendie's solution of morphine (not official). 

This is a 1 to 30 solution of morphine sulphate (or grs. 
xvi to the ounce) . This is a solution which is very commonly 
used for hypodermic administration. It should always be 
fresh, as a fungus often grows in old solutions, and makes it 
unfit for use, or it may change the morphine to apomorphine. 

Morphine Meconate 0.008-0.03 gm. gr. \-% 

(Morphinae Meconas) 

Codeine 

Codeine, one of the active alkaloids of opium, is a com- 
pound of morphine (methylmorphine). Its effects are simi- 
lar to those of morphine, with the following differences: 

1. It does not produce sleep as readily as morphine, and 
the sleep is very light. 

2. It does not slow the breathing as much as morphine, 
and is therefore safer. 

3. It does not produce constipation. 

4. It is not so apt to induce the habit. 

Preparations 

Codeine 0.015-0.06 gm. gr. J-i 

(Codeina) 

Codeine Sulphate 0.015-0.06 gm. gr. f-i 

(Codeina Sulphas) 

Codeine Phosphate 0.015-0.06 gm. gr. J-i 

(Codeina Phosphas) 

Eucodin 0.06 gm. gr. i 

(Methyl Codeine Bromide) 



CEREBRAL DEPRESSANTS 435 

This is used like codeine, as a sedative for cough, but it 
is said to increase the secretion of mucus. 

Narcotine causes muscular twitchings, and thebaine acts 
like strychnine, causing convulsions. Both of these alka- 
loids are not used in medicine. 

Artificial Alkaloids of Morphine 
The following alkaloids are made artificially, by the action 
of various chemical substances on morphine. 

Dionin 

Dionin is an artificial alkaloid made from morphine 
(ethyl morphine). 

Its effects are similar to those of codeine. It is safer than 
morphine, and it does not induce a habit. It is used to pro- 
duce sleep and relieve pain. 

Preparations 
Dionin 0.015-0.06 gm. gr. J-i 

(Dionina) 

Peronine 

Peronine is a substance which has the same effects as 
dionin. It is given in the same doses. 

Heroin 

Heroin is an artificial alkaloid made from morphine by 
its combination with an organic salt of acetic acid (diacetyl 
morphine hydrochloride). Its effects are similar to those of 
morphine with the following differences. 

1. It slows the breathing more. 

2. It does not produce sleep as easily. 

3. It does not induce a habit. 

It is used principally to lessen coughing. 

Preparations 
Heroin 0.0025-0.01 gm. gr. ^-J 

(Heroina) 

Heroin Hydrochloride 0.0025-0.01 gm. gr. ^y-J 

(Heroinae Hydrochloridum) 



436 MATERIA MEDICA 

There are several other drugs which contain alkaloids in 
very small amounts, which act like morphine. The most 
important of these are: 

Sanguinaria Canadensis or Blood Root 
Chelidonium Majus or Celandine 

Lactucarium 

Lactucarium is the dried, milky juice obtained from the 
Lactuca virosa, or garden lettuce. It is occasionally used as 
a substitute for opium, to relieve pain and produce sleep. 
It is given in the form of a tincture, in doses of 0.6-4.0 gms. 
(m. x-3 i) or in the form of a syrup. 

CANNABIS INDICA (INDIAN HEMP) 

Cannabis indica is a resinous substance obtained from 
the flowers of the Cannabis sativa or Indian hemp, a plant 
growing in India, Egypt, and the southern part of the United 
States. 

It is used as an intoxicant in most of the Eastern countries 
in various forms. In India, the dried plant is used for smok- 
ing, either alone or with tobacco, and is called gunjah or 
bhang. Churrhus or hashish is an intoxicating drink con- 
taining the resinous juice, which is used in Arabia and Egypt. 
The resinous substance is also often flavored with sugar or 
honey, and made into a confection. The active principle of 
cannabis indica is said to be a red oil or resin called cannabinol. 

Appearance of the Patient 

About a half to one hour after giving an average dose of a 
reliable preparation of cannabis indica, the patient feels 
drowsy, the sense of pain is lessened, the extremities feel 
numb, the patient often complains of noises in the ear, and 
he soon falls into a deep sleep, lasting several hours, from 
which he usually awakes refreshed. During the sleep, he 
may have particularly vivid beautiful dreams. The pulse 
and breathing are normal and the pupils are dilated. Oc- 
casionally the patient may be somewhat exhilarated before 
falling asleep. 



CEREBRAL DEPRESSANTS 437 

ACTION 

Cannabis indica produces no local effects. 

Internal Action 

When given internally it has a peculiar taste, it produces 
no effect in the stomach and the intestines, but is rapidly- 
absorbed into the blood, from the stomach; and it then acts 
principally on the brain. 

Action on the brain: Cannabis indica lessens the apprecia- 
tion of the various sensations, such as pain, touch, etc. In 
this way, it relieves pain and produces sleep. 

The imagination is increased, however, and the patient 
usually has beautiful vivid dreams, during the sleep. Ideas 
and thoughts arise so rapidly under the effect of cannabis 
indica that time seems to be shorter than it really is, because 
events which otherwise take place over a long period of 
time, seem to occur in a few moments. The judgment 
and reasoning powers of the brain, however, are lessened. 
The pulse and respiration are not usually affected. It dilates 
the pupil. Cannabis indica also increases the sexual desires. 

The effects of different preparations seem to vary. The 
preparations grown in warm climates produce a greater effect 
than those grown in colder climates. Many preparations 
produce no effects. 

Cannabis indica is not a poisonous drug, though large 
doses may make the patient feel alarmed of his condition. 

Effects of Large Doses 

When cannabis indica is taken in large doses, or when it is 
smoked, it usually produces a characteristic state of pleasure 
and exhilaration which accounts for its frequent use as an 
intoxicant. 

Very soon after taking a large amount of hashish, the 
patient goes into a dreamy, drowsy state, during which he 
has the most beautiful dreams, and forgets everything — 
cares, worries, troubles, events which occur about him, 
even the individuals about him. He has visions of the most 
gorgeously beautiful scenes, amidst which he imagines all 



438 MATERIA MEDICA 

sorts of romantic incidents. He is usually joyful and happy, 
and seems to be in a garden of paradise far more beautiful 
than every previous conception of it. 

These dreams are more marked in the languid oriental 
people. Europeans or Americans, unless they are partic- 
ularly emotional, often do not have such extravagant 
dreams, but merely become joyful and happy. 

During this state of exhilaration, ideas arise so rapidly, 
that time seems to pass much faster than usual. Events 
which usually last hours seem to occur in several minutes. 
Often the individual has a sense of impending death, and 
many have a dual personality. This state of exhilaration 
lasts for a short time, perhaps an hour, and the patient then 
falls into a normal, quiet sleep from which he is readily 
awakened. 

The pulse is perhaps a little stronger and faster, the breath- 
ing is normal, and the pupils are dilated. 

In India, the natives often produce a state of catalepsy 
(stiffening of all the muscles) by means of hashish. 

Uses 

Cannabis indica is used to relieve pain and produce sleep 
as a substitute for morphine; in neuralgia, painful menstrua- 
tion, chorea, hysteria, etc. It is an unreliable drug, however, 
as many of its preparations are inactive. 

Preparations 

Extract of Cannabis Indica 0.015-0.06 gm. gr. £-i 

(Extractum Cannabis Indicae) 

Fluidextract of Cannabis Indica 0.1 -0.3 c.c. m. ii-v 
(Fluidextractum Cannabis Indicae) 

Tincture of Cannabis Indica 1.0 -2.0 c.c. m. xv-xxx 

(Tinctura Cannabis Indicae) 

Other Anodynes 
For other drugs which relieve pain see belladonna group, 
page 247. 

Local Anodynes 

For drugs which relieve pain when applied locally, see 
local anaesthetics, page 398. 



ANTIPYRETICS 

Antipyretics are drugs which are used principally to lower 
the body temperature. 

The Temperature of the Body 

The heat of the body is produced by the activity of the 
cells of the various organs of the body and by the contrac- 
tions of the muscles. 

When too much heat is produced, the excessive amount 
of heat is eliminated in the following ways: 

1. By evaporation from the skin. The widened blood vessels 
of the skin contain more overheated blood, and the exces- 
sive heat evaporates from the skin. 

2. By increased perspiration. The perspiration is over- 
heated, and the profuse perspiration eliminates some of the 
heat. 

3. By the exhaled air. The expired air contains more heat ; 
which is then eliminated. 

The heat of the body is kept at a constant temperature, 
usually about 98.6 Fahrenheit, by means of a regulating 
center of gray matter in the brain (situated in the region 
of the corpora quadrigemina) . This is called the heat regu- 
lating center. This center keeps the body temperature always 
at 98.6 F. in the following ways. 

1. When the temperature is below 98.6 F., it is brought 
up to normal again by increased production of heat, by 
means of increased muscular activity, and greater activity 
of the various organs of the body. For example, after a 
convulsion or a chill, which are series of muscular contrac- 
tions, the temperature usually rises several degrees. 

2. When the temperature is above 98.6 F., the temperature 
is lowered to normal again, by the increased elimination of 
heat; which is produced by increased sweating, by dilatation 
of the blood vessels of the skin, and by deeper and faster 
breathing. For example, when the weather is warm and not 
enough heat is lost, the temperature is kept normal by pro- 
fuse sweating, flushed skin, and deeper breathing. 

439 



440 MATERIA MEDICA 

In cold weather, if we are not sufficiently clothed, and 
we are therefore constantly losing heat, more heat is immedi- 
ately produced by the shivering which results. This is a 
series of fine muscular contractions or tremors, which pro- 
duces enough heat to raise the body temperature to normal 
again. 

The sensitiveness of the heat regulating center, varies in 
different individuals. This sensitiveness can be tested by 
observing how low the temperature must be reduced, before 
shivering is produced in a particular individual; or how high 
the temperature must be raised, before sweating is produced. 

Fever 

The bacterial poisons which cause most of the infectious 
diseases, usually affect the heat regulating center in such a 
way, that it keeps the heat of the body regulated for a tem- 
perature higher than normal; perhaps 102 F. or 103 F., etc. 

We then have in these infectious diseases, the higher 
temperature of the body as one of the symptoms of the 
disease. The usual temperature of that disease may be 
said to be its normal temperature. If, however, the tempera- 
ture rises several degrees above the usual, the excessive 
heat is eliminated by sweating, flushed skin, etc., just as in 
the normal individual, until the temperature is lowered again 
to the usual height for that particular disease. 

When the temperature is lower than the usual for that 
particular disease, more heat is produced by shivering, or 
a chill, until the temperature is raised again to the usual 
degree. 

When, however, the infection is overcome, the heat 
regulating center is again set for its normal point 98.6 F. 

Reduction of Temperature 

The temperature can be lowered in three different ways: 

1. By lessening the production of heat. This is accom- 
plished by such drugs as quinine, morphine, aconite, etc., 
drugs which lessen the muscular and other activities of the 
body. 

2. By increasing the elimination of heat. Drugs like pilo- 



CEREBRAL DEPRESSANTS 441 

carpus or morphine which produce sweating, and drugs 
which widen the blood vessels of the skin, such as the ni- 
trites, or the spirits of nitrous ether, reduce the temperature 
in this way. 

3. By setting the heat regulating center for a temperature 
nearer normal, so that the excessive heat is eliminated, and 
less heat is produced. When the temperature is normal, 
these drugs produce no effect. Most of the antipyretics 
in common use act in this way. 

Source of Antipyretics 

The group of drugs which are principally used to lower 
temperature are made by chemical methods from coal tar. 
This is a thick tarry liquid which remains as a sediment, 
together with other substances, after coal has been dis- 
tilled in the manufacture of illuminating gas. 

The effects of these antipyretics are due to paramidophenol, 
and other substances which these drugs form in the body. 

ANTIPYRINE 

Antipyrine is a white crystalline powder which is readily 
dissolved in water. It resembles an alkaloid in its chemical 
properties; combining with acids to form salts. 

Appearance of the Patient 

About fifteen minutes to a half hour after an average 
dose of antipyrine is given, the patient is relieved of headache, 
and nervous pains from which he may have been suffering, 
and he feels calm and quiet. The face is flushed and the 
skin is moist and cool. The pulse and breathing are some- 
what fast at first, but they soon become slower. If the pa- 
tient has a high temperature, it may be reduced one or two 
degrees, and in two or three hours it is reduced to the normal, 
and perhaps to slightly below normal. The effects of anti- 
pyrine last several hours, and then wear off. 

ACTION 
Local action: Applied to the skin or mucous membranes, 



442 MATERIA MEDICA 

antipyrine relieves pain and acts as an antiseptic. It is 
said to check bleeding by contracting the small blood vessels. 

Internal Action 

In the mouth: It has a bitter taste. 

In the stomach and intestines: The secretions are increased. 
It occasionally causes nausea and vomiting in fever patients. 

Action after Absorption 

Antipyrine is rapidly absorbed into the blood from the 
stomach, usually in about fifteen to twenty minutes. After 
absorption it affects principally the brain, the temperature 
and the heart. 

Action on the brain: Antipyrine soothes the action of the 
brain. 

It relieves neuralgic pains and various nervous headaches, 
making the patient calm and quiet without producing sleep. 
The mode of this action is unknown. In some patients, or in 
large doses, it occasionally produces light sleep, possibly 
by lessening the nervous pains and headaches which prevent 
sleep. 

Action on the spinal cord: Antipyrine increases the action 
of the spinal cord. The patient then responds more easily 
to external impulses (increased reflex action). 

Action on the temperature: Antipyrine lowers the tempera- 
ture in fever, about one or two degrees, or even to normal, by 
setting the heat regulating center for a lower temperature. 
The temperature may remain down for several hours. 

Action on the circulation: The pulse is somewhat faster 
at first, but it soon becomes slower and sometimes weaker 
because of the weakened contractions of the heart muscle. 

Action on the respiration : The breathing is somewhat more 
rapid at first, but soon becomes slower. 

Action on the secretory glands: Antipyrine increases the 
perspiration. 

Excretion 

Antipyrine is slowly eliminated from the body by the 
kidney, usually in about twelve to twenty-four hours. 



CEREBRAL DEPRESSANTS 443 

Idiosyncrasies 

In some individuals, such as those that are anaemic, or 
those that have been weakened by prolonged illness, the fol- 
lowing unusual symptoms occasionally occur. 

1. Skin eruptions, redness and itching, often swelling of 
the face and eyelids, which may last for several days. 

2. Nausea and vomiting. 

3. Collapse. 

4. Dizziness. 

Poisonous Effects 

The symptoms of poisoning may follow a single overdose 
of antipyrine, in which case they come on suddenly. Usually 
however, the symptoms result from taking antipyrine con- 
tinually in the form of some patent headache powder to 
relieve headache. 

Symptoms 

1. Difficult rapid breathing. 

2. Slow, weak, irregular pulse. 

3. Cyanosis: This is a blue color of the skin which is 
due to the formation of methaemoglobin in the blood, which 
is a modified form of haemoglobin unable to take up oxygen 
from the lungs. 

4. Nausea and vomiting. 

5. Muscular weakness. 

6. Profuse perspiration. 

7. Twitching of the muscles. 

8. Convulsions. 

9. Collapse (weak, thready pulse, slow shallow breathing, 
and dilated pupils). 

Death results from respiratory paralysis, the patient re- 
maining conscious to the last. 

Treatment 

1. Keep the patient quiet. 

2. Wash out the stomach. 

3. Give atropine, to improve the breathing and lessen the 



444 MATERIA MEDICA 

perspiration; and strychnine, caffeine and other heart stimu- 
lants. 
4. Give inhalations of oxygen to relieve the cyanosis. 

Administration 

Antipyrine is occasionally given hypodermically, and it 
should then be injected deep into the muscles, to prevent 
the formation of abscesses. 

By mouth, it is best given after meals in a little wine, 
iced brandy or in syrup. It is usually given together with 
caffeine to overcome the weakening action on the heart. 

Preparations 

Antipyrine 0.3-1.3 gms. grs. v-xx 

(Antipyrina) 

Antipyrine Salicylate (not official) 0.3-2.0 gms. grs. v-xxx 
(Antipyrinae Salicylas) 
(Salipyrin) 

This is a combination of antipyrine with salicylic acid. 
It is said to relieve rheumatic pains more efficiently than 
either of its constituents alone. 

Ferropyrine (not official) 0.3-1.0 gm. grs. v-xv 

(Antipyrina cum Ferro) 

This is a compound of antipyrine and iron chloride which 
is said to check bleeding. 

ACETANILID (ANTIFEBRINE) 

Acetanilid is a white crystalline powder formed by the 
action of glacial acetic acid, on anilin, a chemical substance 
which is an ingredient of many dyes. It is a neutral sub- 
stance and does not form salts with acids. Chemically it is 
phenylacetamid. It is not readily dissolved in water. 

Appearance of the Patient 

About fifteen to twenty minutes after an average dose of 
acetanilid is given, the patient feels calm and quiet, and 
does not complain of headache or nervous pains from which 



CEREBRAL DEPRESSANTS 445 

he may have been suffering. If the patient has a high tem- 
perature, it is reduced about one or two degrees or even to 
normal, in several hours. The temperature remains down 
for about six to seven hours. 

The face is flushed, perhaps even purple in color. The 
pulse gradually becomes slower and stronger and the breath- 
ing is slower. 

ACTION 

Local action: Applied to the skin or mucous membranes, 
acetanilid relieves pain and is an antiseptic. 

Internal Action 

In the mouth: It has a bitter taste. 

In the stomach and intestines : The secretions are increased 
and it rarely causes nausea and vomiting. 

Action after Absorption 

Acetanilid is absorbed into the blood in about half an 
hour. Here it is changed to paramidophenol, a simpler 
chemical substance which produces most of its effects. After 
absorption it affects principally the brain, the temperature, 
the heart and the blood. 

Action on the brain: Acetanilid is soothing to the brain. 
It relieves neuralgic pains and nervous headache, making the 
patient calm and quiet. In large doses, it occasionally pro- 
duces light sleep. 

Action on the spinal cord: Acetanilid lessens the reflex 
action of the spinal cord, so that the patient does not respond 
so readily to external stimuli. 

Effect on the temperature: The temperature is lowered one 
or two degrees or even to normal, in about two to three hours, 
and it remains down for about six to seven hours. 

Action on the circulation: Acetanilid makes the pulse 
rapid at first, but it soon becomes slower and somewhat 
stronger because of the increased blood pressure. 

Action on the blood: Acetanilid usually affects the red 
blood corpuscles. It changes the haemoglobin to methaemo- 
globin, a substance which cannot readily take up oxygen 



446 MATERIA MEDICA 

from the lungs. This causes the purple or even blue color of 
the face and extremities, often noticed after acetanilid is 
given. With large doses the haemoglobin may even be set 
free in the blood. 

Action on the respiration: The breathing is usually made 
slow and shallow. 

Action on the secretory glands: The perspiration is only 
slightly increased by acetanilid, but it increases the flow 
of urine. 

Excretion 

Acetanilid is excreted by the urine in about twelve to 
twenty-four hours as paramidophenol sulphate. 

Idiosyncrasies 

In some individuals, acetanilid occasionally causes the 
following unusual symptoms: 

1. Skin eruptions, principally areas of redness with itch- 
ing. 

2. Ringing in the ears. 

3. Collapse. 

Poisonous Effects 

The poisonous effects of acetanilid are due principally 
to the formation of methaemoglobin, which prevents the red 
blood cells from combining with oxygen. 

Acute Poisoning 

A single overdose of acetanilid usually causes: 

1. Nausea and vomiting. 

2. Cyanosis, blue color of the face and extremities. 

3. Rapid, weak, irregular, thready pulse. 

4. Shortness of breath with difficult breathing. 

5. Cold, moist skin. 

6. Subnormal temperature. 

7. Collapse. 

8. Stupor, coma and death. 

Chronic Poisoning 

This is by far the most common form of acetanilid poison- 



CEREBRAL DEPRESSANTS 447 

ing and results from the indiscriminate use of headache 
powders containing acetanilid. 

Symptoms 

1. Cyanosis. 

2. Shortness of breath. 

3. Rapid, irregular, thready pulse. 

Administration 

Acetanilid is best given in wine, whiskey or syrup after 
meals. It is usually combined with caffeine, to overcome its 
weakening action on the heart. 

Preparations 

Acetanilid 0.06-0.6 gm. grs. i-x 

(Acetanilidum) 

Compound Acetanilid Powder 0.5 gm. grs. viii 

(Pulvis Acetanilidi Compositus) 

This consists of 7 parts of acetanilid, 1 part of caffeine 
and 2 parts of sodium bicarbonate. 

PHENACETINE (ACETPHENETIDIN) 

Phenacetine or acetphenetidin, is a white crystalline 
powder derived from paramidophenol. 

Appearance of the Patient 

About fifteen minutes to a half an hour after an average 
dose of phenacetine is given, the patient is relieved of neural- 
gic pains or headache from which he may have been suffer- 
ing. If he has temperature, it may be reduced about three 
degrees or even to normal in about three to four hours 
accompanied by profuse sweating. The pulse and respira- 
tion are usually not very much affected. 

ACTION 

Local action: Applied to the skin or mucous membranes, it 
slightly relieves pain and is an antiseptic. 



448 MATERIA MEDICA 

Internal Action 

In the mouth: It has a bitter taste. 

In the stomach and intestines: It increases the secretions 
occasionally causing nausea. 

Action after Absorption 

Phenacetine is absorbed into the blood from the stomach; 
usually in about a half to one hour. After absorption it 
affects principally the nervous system, the temperature and 
the blood. 

Action on the nervous system: Phenacetine is soothing to 
the nervous system. It relieves neuralgic pains and headache, 
and makes the patient calm and quiet. 

Effect on the temperature : Phenacetine reduces the tempera- 
ture in fevers about three degrees or even to normal, in three to 
four hours. The temperature remains down for several 
hours, and its reduction is accompanied by profuse sweating. 
It occasionally lowers the normal temperature slightly. 

Action on the blood: Phenacetine affects the red blood 
corpuscles; changing their haemoglobin to methaemoglobin 
which is unable to combine with the oxygen. This often 
causes a purple color of the face or extremities, or even 
cyanosis. 

The heart and respiration are very little or not at all af- 
fected by phenacetine. It is therefore a safer drug than 
either antipyrine or acetanilid. 

Poisonous Effects 
Overdoses of phenacetine cause : 

1. Cyanosis. 

2. Shortness of breath. 

3. Weak pulse. 

4. Stupor. 

Preparations 
Phenacetine 0.3-1.0 gm. grs. v-xv 

(Acetphenetidinum) 

Thermodin or Phenacetine Ure- 

thane (not official) 0.3-1.0 gm. grs. v-xv 

(Acetylparethoxy) 



CEREBRAL DEPRESSANTS 449 

This is a compound of phenacetine and urethane. Its 
effects are similar to those of phenacetine. 

NEW AND NON-OFFICIAL ANTIPYRETICS 

There are a large number of drugs made from coal tar, 
which are frequently used as antipyretics, but they are not 
official. Many of them are said to be safer than either anti- 
pyrine, acetanilid, or phenacetine. Only the most important 
ones are given here, as new ones are constantly being made. 

Many patent headache powders contain antipyretics, 
and these frequently produce poisonous effects from their 
continued use. 

PYRAMIDON 

Pyramidon is an artificial chemical substance which acts 
like antipyrine. It relieves nervous pains and headaches. 
It reduces temperature slowly, but the temperature stays 
down longer. It is usually given together with caffeine, 
because of its weakening action of the heart. 

Preparations 

Pyramidon 0.06-0.4 gm. grs. i -vi 

(Dimethylaminoantipyrina) 

Pyramidon Acid Camphorate 0.6 -1.0 gm. grs. x -xv 

Pyramidon Neutral Camphorate 0.5 -0.8 gm. grs. viii-xii 

The last two preparations are said to be safer than pyrami- 
don. 

Triphenin 0.3-1.0 gm. grs. v-xv 

This is a derivative of phenacetine. It acts like phenace- 
tine, but its effects are slow and milder. 

PHENOCOLL 

Phenocoll is an artificial chemical substance which acts 
like phenacetine, but it is said to be safer. It has been used 
as a substitute for quinine in malaria. 



450 



MATERIA MEDICA 



Preparations 
Phenocoll Hydrochloride 0.3-1.3 gm. grs. v -xx 

Phenocoll Salicylate 1.0-2.0 gms. grs. xv-xxx 

This combines the effect of phenocoll with salicylic acid, 
and is used to relieve rheumatic pains. 

Salocoll 0.5-1.0 gm. grs. viii-xv 

The following less important unofficial antipyretics are 
occasionally used. Their effects are similar to those of the 
other antipyretics. 

Thalline 0.2 -0.5 gm. grs. iii-viii 

Exalgine 0.06-0.6 gm. grs. i -x 

This resembles acetanilid in its action, but it is said to be 
safer. It occasionally causes dizziness, trembling and weak- 
ness of the eyelids. 

Lactophenine 0.5-1.0 gm. grs. viii-xv 

Thermodine 0.5-1.0 gm. grs. viii-xv 

Neurodine 0.5-1.0 gm. grs. viii-xv 

Malakine 

Saliphen 0.5-1.0 gm. grs. viii-xv 

Salophen 

These substances break up in the body, forming salicylic 
acid. They therefore relieve rheumatic pains, besides 
lowering the temperature. Malakine occasionally produces 
sweating. 
Antikamnia 
Antinervine 
(Consisting of ammonium 

bromide, salicylic acid 

and acetanilid.) 
Benzanilide 
Exodyne 
Phenolide 
Analgen 
Hydracetine 
lodophenine 
Methacetine 
Thymacetine 
Asaprol 



0.6-1.0 gm. grs. x-xv 
These are proprietary prepara- 
tions which produce the same ef- 
fects as acetanilid. 



0.2-0.6 gm. grs. iii-x 
These are proprietary prepara- 
tions which act like phenacetine. 
0.3-2.0 gms. grs. v-xxx 



CEREBRAL DEPRESSANTS 451 

This relieves pain, reduces temperature, checks bleeding, 
lessens nervousness, produces sleep, and increases the flow 
of urine. It occasionally increases the perspiration. It is 
often used as lotions of 1-5% solutions. 
Migrainin 1.0 gm. grs. xv 

This consists of antipyrine, caffeine and citric acid. 

USES OF THE ANTIPYRETICS 

The antipyretics were originally used principally to re- 
duce fever. Owing to their weakening action on the hearty, 
and to the formation of methaemoglobin, which most of 
them cause, they are not used for this effect as much as 
formerly. Cold baths, cold sponges, etc., have taken their 
place. These are preferable to reduce fever, as they do not 
affect the heart or blood. 

The antipyretics are very useful drugs, however, and are 
now principally used to relieve indefinite pains and nervous 
headaches. 

Better results are often obtained by combining small 
doses of several of these drugs, instead of giving an average 
dose of a single one. They are usually given together with 
caffeine, or some other heart stimulant, to overcome the 
weakening action on the heart. 

There are several combinations of antipyretics which are 
commonly used to relieve headache and nervousness, such as 

Caffeine 1 

Acetanilid \ C. A. P. Capsules 

Phenacetine J 
or 

Pyramidon 
Caffeine 

These combinations are usually put up in capsules or 
powders. There are numerous headache powders on the 
market, which consist mainly of one or a number of these 
various antipyretics. 



452 



MATERIA MEDICA 



TABLE OF COMPARATIVE ACTION OF PRINCIPAL 
ANTIPYRETICS 



Name of 
Drug 


Anodyne 
Action 


Effect on 
Tempera- 
ture 


Action on 
the Heart 


Action on 
the Res- 
piration 


Action 
on the 
Blood 


Poison- 
ous 
Effects 


Antipyrine. 


Relieves 

neuralgic 

pains. 


Lowered 

1-3 degrees 

for 2-3 

hours. 


Pulse faster 

at first, then 

slower. 


Breathing 

faster at 

first, then 

slower. 


Checks 
bleeding. 


Occa- 
sional 
col- 
lapse. 


Acetanilid. 


Same. 


Lowered 

1-2 degrees 

for 6-7 

hours. 


Pulse faster 

at first, then 

slow and 

strong. 


Breathing 
slower. 


Cyano- 
sis. 


Col- 
lapse. 


Phenacetine. 


Same. 


Lowered 
2-3 degrees 

for 3-4 

hours, with 

profuse 

sweating. 


No effect. 

Pulse faster 

at first, then 

slower. 


No effect. 


Same. 




Pyramidon. 


Same. 


Lowered 

2-3 degrees 

for 4-5 

hours. 


Breathing 

faster at 

first, then 

slower. 




Col- 
lapse 
occa- 
sion- 
ally. 


Phenocoll. 


Same. 


Lowered 

1-2 degrees 

for 2-3 

hours. 


Slight ef- 
fect. 


Slight 
effect. 







ANTISPASMODICS 

Antispasmodics are drugs which relieve " nervousness." 
The following drugs relieve various indefinite symptoms 
known as nervousness. These symptoms occur in hysteria 
and neurasthenia. In these conditions patients are more 
susceptible to all sensory impulses, and they are more emo- 
tional. They are usually restless, they lack concentration, 
and suffer from lack of sleep. They are usually more irri- 
table and have all sorts of indefinite pains and aches. These 
symptoms are relieved by many of the drugs in this group 
in an unknown way. Probably, they produce their effects 
by suggestion. Most of them have a very strong unpleasant 
odor, which makes the patients think they are taking a 
very efficient remedy and the symptoms therefore improve. 

Because these drugs often relieve the nervous twitchings 
of the muscles, as well as the other symptoms of neurasthenia 
or hysteria, they are often called antispasmodics. 

VALERIAN 

Valerian is obtained from the roots and underground 
stems of the Valeriana officinalis, a European plant. Its 
active principle is a volatile oil which has a very unpleasant 
odor; especially when it is old. It also contains valerianic 
acid and other substances. It was formerly used in England 
as a perfume. 

Appearance of the Patient 

After a preparation of valerian is given, the patient be- 
comes calm and quiet and his nervousness is lessened. 

ACTION 

Valerian has no local action. 

When given internally, it produces the following effects: 
1. It has an unpleasant taste and odor, it checks the for- 
mation and aids in the expulsion of gas from the stomach 

(carminative action). 

453 



454 MATERIA MEDICA 

2. It allays nervousness, and makes the patient calm and 
quiet; probably because of its unpleasant taste and odor. 

3. It makes the pulse a little faster and stronger. 

4. It is said to increase the sweat and the urine. 



Preparations 

Fluidextract of Valerian 2.0-4.0 c.c. 3 ^-i 

(Fluidextractum Valerianae) 

Tincture of Valerian 4.0-12.0 c.c. 3 i — iii 

(Tinctura Valerianae) 

Ammoniated Tincture of Valerian 4.0-12.0 c.c. 3 i -iii 
(Tinctura Valerianae Ammoniata) 

New and Non-official Preparations 

Valyl 0.12 gm. grs. ii 

(Valeryldiethylamidum) 

This usually comes in "pearls," two or three of which are 
given after meals. 

Validol 0.6-1.0 c.c. m. x-xv 

(Menthyl Valerianate) 

This is a compound of menthol and valerianic acid. It 
acts like valerian, but is much more pleasant to the taste 
and has a marked carminative action. It is best given in 
10 to 15 drop doses on a lump of sugar. 

Validol Camphorate 0.6-1.0 c.c. m. x-xv 

This acts like validol, but because of the camphor which 
it contains, it is somewhat strengthening to the heart, and it 
relieves pain when locally applied. 

Bornyval 0.25-0.75 c.c. m. iv-xii 

This is Borneol isovalerate, which forms a large part of 
the oil of valerian, the active principle of valerian. 

Brovalol 0.25-0.75 c.c. m. iv-xii 

Gynoval 0.25-0.5 gm. grs. iv-viii 

This acts like valerian but it is more pleasant to take. 



CEREBRAL DEPRESSANTS 455 

ASAFOETTDA 

Asafoetida is a gum resin obtained by incising the root 
of the Ferula narthex, a plant which grows in Afghanistan in 
India. It consists of a gum resin and a volatile oil which is 
the active principle. Asafoetida is frequently used in India 
as a condiment. 

Appearance of the Patient 

After giving an average dose of asafoetida, the patient 
complains of its unpleasant taste. He becomes calm and 
quiet and less nervous. 

ACTION 

Local action: Applied to the skin or mucous membrane, 
it causes slight redness. 

Internal Action 

In the mouth: It has a very unpleasant nauseous taste, 
and an odor resembling garlic. 

In the stomach: It checks the formation and aids the ex- 
pulsion of gas (carminative action), and it increases the 
secretions. In the intestines: It increases the secretions 
and peristalsis and helps to expel gas. It causes frequent 
movements of the bowels. 

Action after Absorption 

Asafoetida is readily absorbed from the stomach. After 
absorption, it slightly increases the secretion of saliva, sweat 
and urine. The secretion of mucus from the bronchi is 
also increased. It acts therefore as a stimulating expecto- 
rant. Asafoetida acts as a disinfectant on all the secretions. 

Action on the nervous system: Asafoetida makes the pa- 
tient calm and quiet and allays nervousness; probably be- 
cause of the suggestion produced by its very unpleasant 
taste and odor. 

Poisonous Effects 

Overdoses of asafoetida produce severe nausea and vomit- 
ing. 



456 MATERIA MEDICA 

Preparations 

Emulsion of Asafoetida 15.0-30.0 c.c. 3 \-\ 

(Emulsum Asafoetidae) 

This is given by mouth, or in an enema; to relieve disten- 
tion. 

Tincture of Asafoetida 1.0-2.0 c.c. m. xv-xxx 

(Tincture Asafoetidae) 

Pills of Asafoetida 1 -3 pills 

(Pillulae Asafoetidae) 
Each pill contains 0.2 gm. (grs. hi) of asafoetida. 

MUSK (MOSCHUS) 

Musk is the dried secretion of the glands situated in front 
of the prepuce of the Moschus moschiferus, or the musk 
deer of Thibet. It is a dark brown substance, with a very 
strong characteristic odor. 

ACTION 

Owing to the difficulty of obtaining a reliable preparation, 
musk often produces no effects. If the preparation is a 
good one, it produces the following effects: 

1. It relieves nervousness and calms and quiets the patient. 

2. It is said to make the pulse stronger and faster. 

3. It often relieves hiccough. 

Large doses have occasionally caused headache, dizziness, 
confusion, and muscular twitchings followed by sleep. 





Preparations 




Musk (powder) 


0.5-1.0 gm. 


grs. viii-xv 


(Moschus) 






Tincture of Musk 


4.0-8.0 c.c. 


3 i-ii 


(Tinctura Moschi) 


SUMBUL 





Sumbul or vegetable musk is obtained from the root and 
underground stems of the Ferula sumbul, a plant which is 
very little known. Its active principle is a volatile oil. 



CEREBRAL DEPRESSANTS 457 

It is used principally to allay nervousness and make the 
patient calm and quiet. It may be given in large doses. 

Preparations 

Extract of Sumbul 0.25 gm. grs. iv 

(Extractum of Sumbul) 

Fluidextract of Sumbul 2.0 c.c. m. xxx 

(Fluidextractum Sumbul) 

CIMICIFUGA (BLACK SNAKEROOT) 

Cimicifuga is obtained from the roots and underground 
stems of the Cimicifuga racemosa, an American plant which 
grows abundantly in shady woods. Its active principle 
is probably a volatile oil, though it also contains a resin and 
tannic acid. 

ACTION 

When given internally,' cimicifuga produces the following 
effects : 

1. It lessens nervousness and quiets the patient. 

2. It increases the appetite and aids digestion. 

3. It increases the secretion of sweat and urine. 

4. It increases the secretion of the bronchi, and acts as an 
expectorant. 

Large doses cause symptoms resembling those of digitalis 
poisoning. 

1. Slow, strong pulse. 

2. Slow and shallow breathing, headache, dizziness and 
weakness. 

Preparations 

Extract of Cimicifuga 0.3-1.0 gm. grs. v-xv 

(Extractum Cimicifugae) 

Fluidextract of Cimicifuga 1.0-4.0 gms. m. xv-5 i 

(Fluidextractum Cimicifugae) 

Tincture of Cimicifuga 4.0-8.0 c.c. 5 i-ii 

(Tinctura Cimicifugae) 



458 MATERIA MEDICA 

HUMULUS LUPULUS (HOPS) 

Hops are the dried cones which consist of scales, of the 
Humulus lupulus, or hop vine, a plant growing in England, 
northern Europe, and the United States. At the base of 
the scales, there is a yellow powder called lupulin. The 
active principle of hops is a volatile oil. 

ACTION 

When locally applied, hops relieves pain and causes redness 
of the skin. 

When taken internally, it produces the following effects: 

1. It increases the appetite and aids digestion. 

2. It is soothing to the brain and lessens nervousness, 
and may even produce light sleep. 

3. It contracts mucous membranes. 

4. It is said to increase the perspiration. 

Administration 

Locally, hops are usually applied in the form of bags con- 
taining the crude hops. These are soaked in water, wrung 
out, and applied locally. They are often used dry and heated, 
for local effect, or as pillows to produce sleep. 

Preparations 

Lupulin (powder) 0.3-1.2 gm. grs. v-xx 

(Lupulinum) 

Fluidextract of Lupulin 2.0-8.0 c.c. 5 i~ii 

(Fluidextractum Lupulini) 

Oleoresin of Lupulin 0.1-0.3 gm. grs. ii-v 

(Oleoresinae Lupulini) 

COMPOUND SPIRITS OF ETHER (HOFFMAN'S ANODYNE) 

Compound spirits of ether, or Hoffman's anodyne, is 
used principally to lessen nervousness and calm the patient. 
It also checks the formation of gas in the stomach. Its 
effect is due principally to the ethereal oil, or oil of wine, 
which it contains. This is a substance which is formed by 



CEREBRAL DEPRESSANTS 459 

distilling alcohol with sulphuric acid and then diluting the 
resulting fluid with ether. 

Preparations 

Compound Spirits of Ether 2.0-4.0 c.c. 5 J-i 

(Spiritus Aetheris Compositus) 

(Hoffman's Anodyne) 

The following preparations are occasionally used to relieve 
nervousness and to make the patient calm and quiet. 
Acetic Ether 1.0 c.c. m. xv 

(Aether Aceticus) 

This resembles ether, but it does not evaporate very easily. 

Monobromated Camphor 0.3-1.0 gm. grs. v-xv 

(Camphora Monobromata) 

This resembles camphor in its action. 
Camphor is also used to lessen nervousness and quiet the 
patient. 

CYPRIPEDIUM 

Cypripedium is obtained from the roots and underground 
stems of Cypripedium pubescens or ladies' slipper, and from 
Cypripedium parviflorum or moccasin plant, two American 
plants. The active principle of these plants is a volatile oil. 

It relieves nervousness and quiets the patient and it has 
been used for a substitute for valerian. 

Fluidextract of Cypripedium 1.0-2.0 c.c. m. xv-xxx 
(Fluidextractum Cypripedii) 

SCUTTELARIA 

Scuttelaria is obtained from the Scuttelaria lateriflora 
or skull cap, an American plant. It relieves nervousness 
and quiets the patient. 

Fluidextract of Scuttelarium 4.0 c.c. 5 i 

(Fluidextractum Scuttelariae) 

TUSSOL (not official) 

Tussol or Antipyrin mandelate, is used in doses of 0.03- 
0.3 gm. (grs. it-v), to lessen nervousness. 



CHAPTER XVIII 

DEPRESSO MOTORS 

Depresso motors are drugs which lessen muscular contrac- 
tions. The contractions of the muscles can be lessened in 
the following ways: 

1. By acting on the muscles. 

2. By acting on the nerve endings in the muscles. 

3. By lessening the action of the motor cells in the gray 
matter of the spinal cord. 

4. By lessening the action of the cells in the gray matter 
of the motor areas of the brain. 

GELSEMIUM 

Gelsemium is obtained from the roots and underground 
stems of the Gelsemium sempervirens, yellow jasmine, or 
Carolina jasmine, a climbing plant of the southern United 
States. Its active principles are two alkaloids; gelsemine 
and gelseminine, the gelsemine being the more active of the 
two. 

Appearance of the Patient 

About fifteen minutes to a half hour after giving a dose 
of gelsemium, the patient feels tired and languid. The pulse 
is perhaps somewhat slower and weaker. If the patient has 
had muscular twitchings, these are lessened. 

ACTION 

The only local effect produced by gelsemium is the dilata- 
tion of the pupil, which follows its application to the con- 
junctiva. 

Internal Action 

When taken internally, gelsemium is readily absorbed 
into the blood in about fifteen to twenty minutes, and it 

460 



DEPRESSO MOTORS 461 

then affects principally the muscles, the respiration and 
slightly the heart. 

Action on the muscles: Gelsemium lessens the contractions 
of the muscles by paralyzing their nerve endings, which re- 
ceive the impulses to make them contract. In this way 
it lessens muscular twitchings, which are very fine muscular 
contractions. 

Action on the respiration: Large doses of gelsemium make 
the breathing slow and shallow. 

Action on the circulation: The pulse is made slower and 
weaker by large doses. 

Excretion 

Gelsemium is rapidly eliminated from the body by the 
urine, usually in about two to three hours. 

Poisonous Effects 

An overdose of gelsemium usually causes the following 
serious symptoms; which may often endanger the patient's 
life. 

Symptoms 

1. The patient becomes tired, languid and drowsy, but 
does not fall asleep. 

2. The movements of the muscles become weak and un- 
steady, the jaw drops, the eyes may be tired, or the eyelids 
may droop, and the pupils dilate. The speech is often 
indistinct, and the patient staggers as soon as he attempts 
to walk. (These symptoms are due to the beginning paraly- 
sis of the muscles.) 

3. Occasionally there is nausea and vomiting with profuse 
flow of saliva. 

4. The skin is moist, cold and insensitive to pain. 

5. The pulse is slow and weak. 

6. The breathing becomes very slow and shallow, and 
death results from the paralysis of the breathing. 

The patient is conscious to the last, though there may 
be partial blindness before death. 



462 MATERIA MEDICA 

Treatment 

1. Wash out the stomach. 

2. Keep the patient quiet. 

3. Give artificial respiration. 

4. Give heart stimulants such as atropine, strychnine, etc. 

Uses 

Gelsemium is used principally to relieve the very painful 
spasms of the muscles of the face in " tic douleureux" or tri- 
geminal neuralgia. 

Preparations 

Fluidextract of Gelsemium 0.3-0.6 c.c. m. v-x 

(Fluidextractum Gelsemii) 

Tincture of Gelsemium 0.3-1.0 c.c. m. v-xv 

(Tinctura Gelsemii) 

CONIUM (SPOTTED HEMLOCK) 

Conium is obtained from the fruit and flowers of the 
Conium maculatum, or poison hemlock, a European plant. 
Its active principle is coniine, a volatile fluid alkaloid. 

ACTION 

Applied locally, conium causes intense redness and swelling. 
When taken internally, it acts like gelsemium, causing 
muscular weakness by paralyzing the nerve of the muscles. 
In large doses it slows the breathing. 

Poisonous Effects 

Conium poisoning has become famous as having been the 
means with which Socrates, the famous Greek philosopher 
was killed; poison hemlock being the means of killing crimi- 
nals in Athens in Socrates' time. 

Symptoms 

1. The lower extremities become weak and heavy. The 
patient lies down because of the weakness. If he attempts 



DEPRESSO MOTORS 463 

to walk, he staggers and falls. The eyes may be turned in, 
the lids may droop, and the pupils are dilated. The patient 
complains of headache and he can hardly lift his head. 

2. The pulse is slow at first, but soon becomes rapid and 
weak. 

3. The skin is moist and cold. 

4. The breathing becomes slow and shallow, and the 
patient dies in a short time from arrest of breathing. 

Uses 

Conium is very rarely used at present, possibly once in a 
great while to lessen the spasms of whooping cough. It is 
a very dangerous drug. 

Preparations 

Fluidextract of Conium 0.1-0.5 c.c. m. ii-viii 

(Fluidextractum Conii) 

SPARTEINE 

Sparteine is a fluid alkaloid which is contained in scoparius 
or broom tops. 

ACTION 

When given internally, its effects appear in half an hour 
and last for several hours. It is absorbed from the stomach, 
and it then acts like gelsemium or conium. It weakens 
muscular contractions by paralyzing the nerve endings in 
the muscles. It is not as poisonous as either of these drugs, 
but it affects the heart more. 

Action on the heart: Sparteine makes the heart beat slower 
and weaker; by weakening the contractions of the heart 
muscle, thereby causing a slow, weak pulse. 

Sparteine was formerly considered a heart stimulant, 
but its use for this purpose has been given up, as its action 
seems to contraindicate this use. 

Sparteine does not increase the flow of urine as does 
scoparius, the crude drug from which it is obtained. 



464 MATERIA MEDICA 

Poisonous Effects 

The poisonous effects of sparteine are the same as those 
of conium. 

Preparations 

Sparteine Sulphate 0.004-0.1 gm. gr. T y-ii 

(Sparteinae Sulphas) 

LOBELIA (INDIAN TOBACCO) 

Lobelia is obtained from the leaves and tops of the Lobelia 
inflata or Indian tobacco, an American plant. Its active 
principle is an alkaloid lobeline. 

ACTION 

When taken internally, lobelia produces the following 
effects : 

1. It increases the secretions of the stomach and intes- 
tines, often causing nausea and vomiting, and occasionally 
frequent movement of the bowels. 

2. It lessens the contractions of the involuntary muscles of 
the bronchi. 

3. It increases the secretions; such as the saliva, the mucus 
from the bronchi, etc. 

4. The pulse is usually slower, but soon becomes rapid and 
weak. 

5. The breathing is somewhat slower. 

Poisonous Effects 

An overdose of lobelia usually causes: 

1. Nausea, and profuse vomiting. 

2. Occasionally frequent movements of the bowels. 

3. Great weakness and relaxation of the muscles. 

4. Collapse (rapid thready pulse, slow shallow breathing, 
cold moist skin, and dilated pupils). 

5. Convulsions, stupor, coma and death from paralysis 
of the breathing. 

Uses 

Lobelia is occasionally used to lessen the contractions of 



DEPRESSO MOTORS 465 

the involuntary muscles of the bronchi, in asthma; but be- 
cause of its dangerous poisonous effects, its use has mostly 
been given up. It is occasionally used in the form of an 
infusion, to relieve poison ivy rash. 

Preparations 

Fluidextract of Lobelia 0.06-0.3 c.c. m. i-v 

(Fluidextractum Lobeliae) 

Tincture of Lobelia 0.6-4.0 c.c. m. x-5 i 

(Tincture Lobeliae) 

TABACUM (TOBACCO) (not official) 

Tobacco is the dried leaves of Nicotiana tabacum, a plant 
growing in tropical countries. It contains nicotine, a very 
poisonous volatile fluid alkaloid. It also contains pyridine^ 
a substance which acts like nicotine, tobacco camphor and an 
oil. 

Tobacco is not used as a medicine, but it is habitually 
used as a luxury by many individuals. It is smoked in the 
form of cigarettes or cigars, it may be chewed or taken as 
snuff. 

ACTION 

Tobacco, because of its nicotine acts like lobelia. It lessens 
the contractions of all the involuntary muscles. A strong 
cigar will often relieve an attack of asthma, by lessening the 
contractions of the involuntary muscles of the bronchi. 

It increases the peristalsis and often acts as an excellent 
cathartic. It increases the flow of urine. 

In persons who do not smoke habitually, tobacco often 
causes nausea, vomiting, headache, dizziness and weakness. 
In those who smoke habitually, it does not produce such 
effects. 

Poisonous Effects 

Nicotine is one of the most violent poisons known. It 
causes symptoms like those of lobelia poisoning, which come 
on very rapidly and cause death. 

Chronic tobacco poisoning is a frequent condition which 



466 MATERIA MEDICA 

follows excessive smoking. The symptoms are due to the 
nicotine which the tobacco contains. The patient usually 
complains of palpitation of the heart, he has a rapid irregular 
pulse and is very nervous. 

CURARA (not official) 

Curara, woorara, woorali or urari, is an arrow poison which 
is used by the South American Indians. It is made 
from the bark of various trees, such as the Strychnos toxi- 
fera. Its active principle is an alkaloid, curarine. It is 
rarely used in practical medicine, but it is frequently used 
in animal experiments. 

Curara paralyzes the nerve endings of all the muscles, 
thereby lessening their contractions. It causes a rapid weak 
pulse, by making the heart beat faster as a result of the 
paralyzed nerve endings of the Vagus nerve in the heart, 
which curara causes. The blood pressure is lowered, how- 
ever. 

It increases peristalsis and all the secretions. Curara is 
occasionally used to lessen the spasms of tetanus, hydro- 
phobia, etc., but its use is dangerous on account of its weaken- 
ing action on the heart. It is given in doses of gr. \) or 
curarine, the alkaloid is given in doses of gr. tut - tK- 

For other drugs which lessen contractions of involuntary 
muscles, see the belladonna group and morphine. 



UTERINE SEDATIVES 

The following drugs are used principally to lessen con- 
tractions of the uterus, and to lessen the pains which these 
often produce. 

VIBURNUM PRUNIFOLIORUM (BLACK HAW) 

Viburnum is obtained from the root of the Viburnum 
prunifoliorum or black haw, a small American plant. 

ACTION 

It lessens the contractions of involuntary muscles, espe- 
cially the muscles of the uterus. It soothes uterine con- 
tractions, and is said to check colic and cramps. 

It is used principally to relieve painful or excessive menstrua- 
tion, and to relieve the pains of ovarian disease. 

Preparations 
Fluidextract of Viburnum Pruni- 
foliorum 2.0-16.0 c.c. 5 ibiv 
(Fluidextractum Viburni Prunif olii) 

VIBURNUM OPULUS (CRAMP ROOT) 

Viburnum opulus, or cramp root, is obtained from the 
bark of the Viburnum opulus, a small American tree. 

It acts like viburnum prunifoliorum, but is less soothing 
to the uterus and is said to relieve colic and cramp-like pains, 
more than viburnum prunifoliorum. 

Preparations 
Fluidextract of Viburnum Opulus 2.0-16.0 c.c. 5 i-iv. 
(Fluidextractum Viburni Opuli) 

There are a number of drugs which lessen, or soothe 
uterine contractions, but which have other more important 
effects. The most common of these are: 
Morphine 
Atropine 

Antipyretic group 
(Acetanilid) 
(Antipyrine) 
(Phenacetine) 
(Pryamidon) 
467 



SECRETORY DEPRESSANTS 

Secretory depressants are drugs which are principally 
used to check the secretions of the various secretory glands 
of the body. 

The most efficient and best drugs for this purpose are the 
drugs belonging to the belladonna group, which have already 
been described under their other more important effects. 



AGARICUS AND AGARICIN 

Agaricus is a fungus, the white agaric, or Agaricus albus 
or Boletus laricis. This fungus grows on the European larch 
tree. 

Its active principle is an acid, agaricinic acid, or agaricin, 
which is the preparation principally used. 

ACTION 

Agaricin checks the secretion of sweat, by paralyzing the 
nerve endings in the sweat glands which cause secretion. 
The effect however, is not as marked as after atropine. 
Secretions of the other secretory glands are not affected by 
agaracin. It often causes nausea and frequent movements 
of the bowels. It does not affect the heart, respiration or 
pupil. It is used principally to check the night sweats of 
tuberculosis. 

Preparations 

Agaricin 0.005-0.06 gm. gr. T y-i 

This is best given in pill form about five or six hours be- 
fore retiring, as it is very slowly absorbed. 

Agaric Acid (not official) 0.015-0.03 gm. grs. J— J 

(Acidum Agaricum) 

This is a very poisonous substance. Overdoses cause 
vomiting, diarrhoea and collapse. 

468 



DEPRESSO MOTORS 469 

CAMPHORIC ACID 

Camphoric acid is a small white crystalline powder, 
formed by the action of nitric acid on camphor. It is used 
to check sweating. 

Camphoric Acid 1.0-2.0 gms. grs. xv-xxx 

(Acidum Camphoricum) 

THALLEIN ACETATE 0.06-0.2 gm. grs. i-iii 

This is a white crystalline powder used to check night 
sweats. Its continued use is said to cause baldness. 



PART IV— SPECIFICS 
CHAPTER XIX 

SPECIFICS 

Specifics are drugs which are principally used to cure a 
particular disease. This effect is produced by destroying or 
neutralizing the causative agent of that disease. The best 
example of this action, is the effect of quinine in malaria. 
The organism which causes this disease is destroyed by the 
quinine. 

Many of the specifics relieve the symptoms of a particular 
disease, though the mode of action may be unknown. An 
example of this action is the effect of the salicylates in rheu- 
matism. 

CINCHONA AND QUININE 

Quinine is a white powder, an alkaloid, the active princi- 
ple of cinchona, or peruvian bark. This is the bark of the 
cinchona tree, which grows in the Andes or other mountain- 
ous districts on the western coast of South America, though 
the tree has been cultivated successfully in other parts of 
the world, as in India and Java. There are two kinds of 
cinchona; Cinchona rubra, or red bark, and Cinchona calisaya, 
or yellow bark. The effects of both of these forms of cinchona 
are the same, but the yellow bark contains more quinine. 

Cinchona is named in honor of the countess of Cinchon, 
a Spanish countess who was cured in 1638, of a disease that 
was then known as the ague, but what we now know as 
malaria. The drug had just been introduced in medicine 
in that time, having been brought to Spain by the Spanish 
explorers who learned of its use from the South American 
Indians. Besides quinine, the active alkaloid; cinchona con- 
tains the alkaloids quinidine, conquinine, cinchonine, and cin- 

471 



472 MATERIA MEDICA 

chonidine which resemble quinine in their effects, but they are 
weaker. 

Appearance of the Patient 

When quinine is given to a patient suffering from malaria, 
it prevents the chills, fever and sweats, which are character- 
istic of that disease. 

After administration of a single average dose of quinine, 
the patient usually complains of a bitter taste in the mouth, 
he feels brighter, and the pulse is perhaps somewhat faster 
and stronger. If the patient has temperature, this is lowered 
several degrees. 

If the quinine is given for some time, the patient feels 
better, he has a better appetite, his bowels move more 
regularly, he feels brighter and stronger and is more active. 
The pulse is somewhat stronger and faster, the breathing 
is deeper and somewhat faster. 

ACTION 

Quinine affects all living tissues (protoplasm). It increases 
their activities at first, but soon lessens them. All the effects 
of quinine are due to this action. Quinine has no special 
affinity for any particular organ or tissue. 

Various living organisms such as amoebae, bacteria, etc., 
are destroyed by quinine. 

Local action: Applied to the skin or mucous membranes, 
quinine causes slight redness and acts as an antiseptic. It 
is not generally used as an antiseptic, because it is too ex- 
pensive. 

Internal Action 

In the mouth: Quinine has a very bitter taste because of 
which it increases the appetite and the secretion of saliva. 

In the stomach: It increases the secretion of gastric juice 
and aids digestion. In large doses, it occasionally causes 
nausea and vomiting. 

In the intestines: It increases the secretions and peristalsis, 
often causing frequent movements of the bowels. 

Action after Absorption 
Quinine is slowly absorbed into the blood, principally 



SPECIFICS 473 

from the stomach. It begins to be absorbed in about 15 
minutes, but it is not completely absorbed until about four 
or five hours. If a drop of dilute sulphuric acid is added to 
any of the preparations, the drug is more readily absorbed. 
When it enters the blood, it acts as a specific against malaria, 
and it slightly affects the nutrition and the action of all the 
tissues and organs. 

SPECIFIC ACTION IN MALARIA 
Malaria 

Malaria is a disease caused by a unicellular organism, a 
protozoan called the Plasmodium malariae. This organism is 
injected into the blood of the patient, by the bite of a species 
of mosquito, the anopheles. The organisms then enter the 
red blood corpuscles, where they grow and develop into 
other similar organisms in 48 or 72 hours, depending on the 
type of organism. At the end of this time, the red blood 
corpuscles burst, the newly formed malarial parasites, and 
the haemoglobin of the red blood corpuscles, are thrown into 
the blood. 

As a result of the sudden destruction of such a large 
number of red blood corpuscles, the patient has a chill. The 
violent muscular contractions which are thus produced, 
elevate the temperature several degrees, and since this 
temperature is excessive, it is followed by sweating, which 
gradually reduces it to normal. 

These chills, fever and sweats occur every third day, if the 
organism which causes these symptoms is the quartan type, 
or the one which develops in 72 hours. It occurs every other 
day, if the organism is the tertian type or the one which de- 
velops in 48 hours. In some cases, the chills, fever and sweats 
occur every day. This is due to the patient having two 
tertian types of organisms, each one developing in 48 hours, 
but on alternate days. The attacks always come on regularly 
at the same time during the day. 

Effect of Quinine in Malaria 

If a patient suffering from malaria is given quinine, the 



474 MATERIA MEDICA 

quinine enters the blood and destroys the plasmodiae. The 
chills, fever and sweats are then prevented, and the disease 
is cured. The quinine must be continued for some time, 
however, even after the symptoms have disappeared; until 
all the plasmodiae in the blood are destroyed, and the patient 
has no more attacks. 

Action on the nutrition and metabolism: Quinine increases 
the nutrition of the tissues and organs of the body, by pre- 
venting the nitrogenous, or proteid food from being used up 
(combining with oxygen). These foods help to build up 
the patient and conserve the strength. In this way quinine 
acts as a tonic, slightly improving the action of all the tissues 
and organs of the body and making the patient feel better 
and stronger. 

Action on the blood: Besides its destructive action on 
malarial parasites, quinine prevents the red blood corpuscles 
from taking up oxygen as readily as before. It also lessens 
their number and checks the movements of the white blood 
corpuscles. 

Action on the circulation: The pulse is made somewhat 
stronger and faster, because the contractions of the heart 
and blood vessels are increased. Large doses, occasionally 
cause a slow and weak pulse because of the lessened con- 
tractions of the heart. 

Action on the nervous system: Quinine makes the patient 
somewhat brighter and more active. 

Action on the senses of sight and hearing: Large doses 
of quinine very frequently cause ringing in the ears, and 
dimness of vision. 

Action on the uterus: Quinine increases the contractions 
of the uterus during labor, only occasionally causing abortion, 
however. 

Effect on temperature: The temperature is lowered be- 
cause oxidation of the nitrogenous or proteid substances 
of the tissues is lessened, and less heat is produced. 

Excretion 

Quinine is eliminated from the body by the urine, mostly 
in about 6 to 8 hours. 



SPECIFICS 475 

Idiosyncrasies 

Many individuals are especially susceptible to quinine, 
even small doses causing poisonous effects. In some in- 
dividuals, the following unusual symptoms occur, even from 
very small doses. 

1. Eruptions on the skin, such as areas of redness re- 
sembling the scarlet fever rash, hives or urticaria, and oc- 
casionally small blisters. (Herpes.) 

2. Occasionally scanty urine, accompanied by pain; often 
the urine is tinged with blood or haemoglobin. 

3. Slow and weak pulse, and a feeling of weakness. 

Poisonous Effects 

Since quinine is very frequently given in large doses for 
malaria, poisonous effects are not uncommon. These effects 
result from continued use of quinine, or from very large 
doses taken to produce abortion. While the symptoms which 
result may be alarming, they are rarely, if ever, fatal. 

Symptoms 

The first and most characteristic symptom of quinine 
poisoning is: 

1. Ringing in the ears, or roaring sounds in the ears. 
Often the patient may become temporarily deaf. Rarely 
the deafness remains permanent. 

2. Dimness of vision, especially for colors. 

3. Temporary blindness or " color blindness." The blind- 
ness is occasionally permanent. 

4. Nausea and vomiting. 

5. Slow, weak pulse. 

6. Muscular weakness. 

7. Collapse. 

Treatment 

The symptoms usually subside when the drug is stopped. 
If the pulse is weak, caffeine, given hypodermically, or a hot 
coffee enema, usually improves it. 



476 MATERIA MEDICA 

Uses 

Quinine is used principally: 

1. As a specific in malaria. 

2. As a bitter, to increase the appetite and to improve 
the nutrition; as a tonic. 

3. To reduce fever. 

4. In amoebic dysentery, a chronic disease of the intes- 
tines caused by the amoeba, a unicellular organism. In these 
cases quinine is usually given by irrigations into the colon 
or large intestine. It acts by destroying the amoebae. 

Administration 

In malaria, quinine is usually given in one single large 
dose of 1.0 gm. (grs. xv) about 4 hours before the time when 
the chill should occur. It may also be given in divided 
doses, so that the last dose is given about 4 hours before the 
expected chill. By the time the quinine enters the blood, 
the parasities are very young and are readily destroyed. It 
may also be given in divided doses when the temperature 
is going down, after the chill. The administration of quinine 
should be kept up, however, for about a week after the 
attack is over, to prevent a recurrence of the symptoms. 

1. Quinine is best given in solution, as it is then more 
readily absorbed. 

2. It may also be given in powder or pills. Quinine pills 
are usually not very efficient unless they are fresh. Other- 
wise, they may pass out into the stools and are not absorbed. 
The addition of a few drops of dilute sulphuric acid usually 
makes the quinine preparation more soluble. 

3. On account of its unpleasant, bitter taste, quinine 
should be given in sherry wine, in cachets of capsules, or 
some food, such as olive oil, may be given afterwards. 

4. It is best given before meals, as it then increases the 
appetite, and prevents nausea and vomiting. 

Preparations 
Cinchona 
Fluidextract of Cinchona 4.0 c.c. 5 i 

(Fluidextractum Cinchonae) 



SPECIFICS 477 

Tincture of Cinchona 4.0-16.0 c.c. 3 i-iv 

(Tinctura Cinchonae) 

Compound Tincture of Cinchona 2.0-4.0 c.c. 5 iH 
(Tinctura Cinchonae Composita) 

The cinchona preparations are used principally as bitters 
to increase the appetite. For malaria and as a tonic, quinine 
preparations are preferable. 

Quinine 
Quinine 0.3-1.0 gm. grs. v-xv 

(Quinina) 

Quinine Bisulphate 0.3-1.0 gm. grs. v-xv 

(Quininae Bisulphas) 

This is the most common preparation used, as it is the most 
soluble one. 



Quinine Sulphate 
(Quininae Sulphas) 


0.3-1.0 gm. 


grs. v-xv 


Quinine Hydrobromide 
(Quininae Hydrobromidum) 


0.3-1.0 gm. 


grs. v-xv 


Quinine Hydrochloride 
(Quininae Hydrochloridum) 


0.3-1.0 gm. 


grs. v-xv 



Other Alkaloids of Cinchona 

Cinchonine Sulphate 0.5-1.3 gm. grs. viii-xx 

(Cinchoninae Sulphas) 

Cinchonidine Sulphate 0.5-1.3 gm. grs. viii-xx 

(Cinchonidinae Sulphas) 

Compound Preparations 

Iron and Quinine Citrate 0.3-0.6 gm. grs. v-x 

(Ferri et Quininae Citras) 

Syrup of Iron, Quinine and Strychnine 

Phosphate 4.0 c.c. 3 i 

(Syrupus Ferri, Quininae et Strychninae Phosphatum) 

Elixir of Iron, Quinine and Strychnine Phosphate 

4.0 c.c. 3 i 

(Elixir Ferri, Quininae et Strychninae Phosphatum) 

Warburg's Tincture 



478 MATERIA MEDICA 

This is a dark brown liquid which is used extensively in 
India, in the treatment of malaria. It contains a large 
number of ingredients besides quinine, such as aloes, rhubarb, 
gentian, camphor, etc. 

New and Non-official Preparations 

Quinine and Urea Hydrochloride 0.3-1.0 gm. grs. v-xv 
(Quininae et Ureae Hydrochloridum) 

This preparation is suitable for hypodermic use. It is 
also used as a local anaesthetic when injected hypodermically 
or when applied to mucous membranes. 

Quinine Tannate 0.6-2.0 gms. grs. x-xxx 

(Quininae Tannas) 

This preparation is slowly absorbed, and has no bitter 
taste. 
Aristochin 0.3-1.0 gm. grs. v-xv 

This is a chemical derivative of quinine. It is not so apt 
to cause poisonous symptoms. 

Euquinine 0.3-1.0 gm. grs. v-xv 

(Quininae Aethylcarbonas) 

This is a chemical derivative of quinine, which is tasteless. 

Chinaphenin 0.3-0.6 gm. grs. v-x 

This is a compound of quinine and phenacetine. It com- 
bines the quinine action with the anodyne effect of phenace- 
tine. It is tasteless and is not apt to cause poisonous symp- 
toms. 

Quinine Lygosinate 
(Quininae Lygosinas) 

This is a chemical derivative of quinine. It is used as an 
antiseptic dusting powder, or in solution to check bleeding. 
Saloquinine 0.5-2.0 gms. grs. viii-xxx 

This combines the action of quinine with salicylic acid. 
Saloquinine Salicylate 1.0 gm. grs. xv 

This acts like saloquinine. 
Bebeerine 0.06-0.1 gm. grs. i-ii 

This is an alkaloid which is occasionally used as a substi- 
tute for quinine. 



SPECIFICS 479 

PHLORIDZIN (not official) 

Phloridzin is a glucoside obtained from the roots of the 
apple, pear, cherry, and other trees. 

It is occasionally used to destroy malarial parasites. It 
forms sugar in the urine and increases its secretion. It 
is rarely used, except to test the action of the kidney; because 
it is injurious to that organ. 

Preparations 

Phloridizin 0.3-0.6 gm. grs. v-x 

(Phloridizinum) 

MERCURY (HYDRARGYRUM) 

Mercury or quicksilver is a silver colored liquid metal 
which evaporates very easily. Many of its salts are used 
in medicine. 

Appearance of the Patient 

A few hours after giving an average dose of a preparation 
of mercury, the patient usually has several movements of 
the bowels. The stools are soft, colored with bile, and ac- 
companied by a little griping; more urine is also passed. 
Occasionally the flow of saliva is also somewhat increased. 

If small doses of mercury preparations are given contin- 
uously for weeks or longer, to a patient suffering from the 
first or second stage of syphilis, the symptoms, such as the 
original ulcer or chancre, the rash on the body, the mucous 
patches in the mouth, and the swelling of the glands, all 
gradually disappear. 

ACTION 

The salts of mercury combine with the proteids and 
albumins of all living matter, forming an albuminate of 
mercury. It is therefore injurious to, and may even destroy 
all living matter. In this way, it checks the growth of bac- 
teria (antiseptic action), and other living organisms and 
parasites (anti parasiticide). 



480 MATERIA MEDICA 

Local action: Applied to the skin, mercury preparations 
are excellent antiseptics. If a strong solution is used, or 
even a weak solution continuously, redness, pain and itching 
of the skin will result. If a strong solution is kept in contact 
with the skin for a long time, inflammation and even destruc- 
tion of the skin may result. 

Mucous membranes are shrunk and contracted by the 
action of mercury preparations (astringent action). 

Internal Action 

In the mouth: Mercury preparations have a distinct metal- 
lic taste, and contract the mucous membrane. 

In the stomach: They slightly increase the secretions, 
occasionally causing nausea. 

In the intestines: Mercury preparations increase the 
secretions and peristalsis, causing frequent soft stools tinged 
with bile. Here they also act as antiseptics. The large 
amount of bile in the stools which results when mercury 
preparations are given, is due to their antiseptic action; 
which prevents the decomposition of the bile, and also to 
the increased peristalsis of the bile ducts, induced by the 
peristalsis of the duodenum; the part of the intestine, to 
which these ducts are attached. Mercury preparations do 
not increase the secretion of bile, as was formerly supposed. 
The preparations of mercury, such as calomel, which are 
not readily absorbed, are the best ones to use as cathartics. 

Action after Absorption 

Mercury salts are readily absorbed into the blood from 
all the mucous membranes, the lungs, and even by the skin. 
When given by the mouth, they are absorbed in 1 to 2 hours. 
After absorption, they affect principally the intestines, the 
kidney, some of the secretions, the nutrition of the tissues, 
and if given for some time, they act as a specific against the 
first and second stages of syphilis. 

Action on the kidneys: Mercury salts increase the flow of 
urine. 

Action on the secretory glands : All the secretions, especially 
the saliva and pancreatic juice are increased. 



SPECIFICS 481 

Action on nutrition: Small doses of mercury preparations, if 
given for some time, increase the nutrition of the tissues, 
and the body weight. (Alterative action.) 

SPECIFIC ACTION IN SYPHILIS 

Syphilis 

Syphilis is a chronic infectious disease, caused by the 
Spirochaeta pallida, a spiral shaped organism. The infection 
begins by the formation of a hard ulcer, or chancre, usually 
on the genital organs. This is known as the first stage of 
the disease. It is followed in about six weeks, by an erup- 
tion all over the body (roseola), whitish patches in the 
mouth (mucous patches), and swelling of all the lymph 
glands throughout the body. This is known as the second 
stage of the disease. In a short time, for example, in several 
months or several years or at any time during the patient's 
life, the patient may suffer from a number of diseases, which 
result from the formation of gummata, or areas of round cells 
which readily decompose and form a thick fluid in the center. 
Any organ of the body may be affected in this way, produc- 
ing many and very different symptoms. This is known as 
the third stage of the disease. 

Parents infected with syphilis, may transmit the disease 
to their children. The children may then be born dead, 
or they may suffer, if they five, at any time during their 
childhood from various symptoms which are characteristic 
of the third stage of the disease. 

Effect of Mercury 

Mercury preparations, if given continuously for some 
time, to a patient suffering from the first or second stage 
of syphilis, usually relieve all the symptoms in a very short 
time. The rash and the mucous patches soon disappear, the 
glands become smaller, until they too, finally disappear. This 
curative action of mercury in syphilis is probably due to its 
destructive action on the spirochaeta pallida, the organism 
which causes the disease. 



482 MATERIA MEDICA 

Excretion 

Mercury preparations are excreted mainly by the kidneys 
and the intestines, and also slightly, by all the excretions, 
such as the saliva, milk, bile, gastric juice, etc. It is 
eliminated from the body very slowly, usually in one or 
two days. Some of the mercury often remains in the body 
for a long time afterwards, and may then be gradually 
excreted for some time. 

Poisonous Effects 

Mercury poisoning occurs in two forms, acute poisoning 
and chronic poisoning. 

Acute Mercury Poisoning 

Acute mercury poisoning usually results from one of the 
mercury salts, such as the bichloride of mercury tablets, 
taken with suicidal intent. 

Symptoms 

1. Metallic taste in the mouth, and burning pain in the 
throat. 

2. Cramp-like, abdominal pains. 

3. Nausea and vomiting; the vomited matter contains 
bile and later blood. 

4. Diarrhoea with bloody stools. 

5. Scanty urine which may contain blood. 

6. Collapse, as a result of the profuse vomiting and 
diarrhoea; rapid, weak, irregular pulse, the face is pinched 
and anxious, the skin is cold and moist, the breathing slow 
and shallow. 

7. Convulsions and coma may occur before death. 
Often the patient lives several days and then dies from 

severe injury to the kidney, which causes very scanty 
urine, convulsions and coma. Death from mercury poison- 
ing usually occurs in from one to seven days. 

Treatment 

1. The antidote for mercury poisoning is white of egg, milk 
or flour. The albumins which these substances contain 



SPECIFICS 483 

combine with the mercury, forming an albuminate of mer- 
cury, which prevents the poisonous action of the mercury. 
About one egg should be given for every 4 grs. of bichloride 
of mercury taken. 

2. Give opium or morphine to check the diarrhoea, and 
to keep the patient quiet. 

3. Treat the collapse with heart stimulants such as caf- 
feine, atropine, strychnine, etc. 

Chronic Mercury Poisoning " Mercurialism " 

Mercurialism or chronic mercury poisoning is a very 
common condition which results from prolonged use of 
mercury preparations. Syphilitic patients can often take 
large doses of mercury without producing any poisonous 
effects. 

Symptoms 

The first symptom of excessive mercury action is: 

1. Profuse flow of saliva, and a metallic taste in the mouth. 
This is soon followed by: 

2. Soreness and bleeding of the gums, later ulcerations of 
the gums, mouth or throat, loosening of the teeth, and even 
destruction of the jaw-bone. The breath has a very foul 
odor from the destroyed tissue. 

3. Diarrhoea, often with bloody stools. 

4. Anaemia. 

5. Loss of weight. 

6. Scanty urine. 

7. Paralysis of the hands or feet with "drop-wrists" or 
"drop-feet." 

Treatment 

1. Stop the administration of mercury. 

2. The soreness of the gums is best relieved by a potassium 
chlorate mouth wash or a tannic acid mouth wash. The 
gums are often painted with tincture of myrrh. 

3. The diarrhoea is best checked by opium. 

Uses 

Mercury preparations are used principally: 

1. As a specific for the first and second stages of syphilis. 



MATERIA MEDICA 

2. Many of the preparations are excellent antiseptics. 

3. Some of the preparations are excellent purgatives. 

4. Mercury is said to have a very beneficial effect in re- 
lieving acute infections of the serous membranes, such as 
pleurisy, peritonitis; and enlargements of lymph glands. 

Administration 

1. For absorption from the skin, mercury is applied as 
rubbings or inunctions in the form of an ointment. This is 
applied for six days, every day on a different region of the 
body; thus, one day on the arms, another day on the forearms, 
the thighs, the legs, the back, etc. On the seventh day the 
patient is given a bath to get rid of the ointment on his skin 
and then the course is begun again. 

In giving mercury inunctions, the nurse should protect 
her hands with thick gloves, as otherwise she herself may 
absorb the drug, and thus get poisonous effects. 

Another method of giving mercury by the skin, is for the 
patient to sit in a cabinet over a lamp containing calomel, 
which is then burned; the fumes being absorbed by the skin. 
Mercury is also frequently given by the mouth. 

An excellent newer method of giving mercury is by deep 
injections into the muscles. It is usually injected into the 
muscles of the buttocks, which are then rubbed very thor- 
oughly to hasten the absorption. 

Preparations 

Bichloride of Mercury 0.0012-0.006 gm. gr. ^- T V 

Corrosive Sublimate 

(Hydrargyri Chloridum Corrosivum) 

This is rarely used internally, but principally as a local 
antiseptic in 1-1000 to 1-5000 solutions. It usually comes 
in tablets of 0.5 gm. (grs. vii i) each, which are dissolved in 
water to make up the required strength. Corrosive subli- 
mate cannot be used to disinfect instruments, as it stains 
them black. 

Mild Mercurous Chloride 0.006-0.3 gm. gr. T Vv 

Calomel 

(Hydrargyri Chloridum Mite) 



SPECIFICS 485 

This preparation is used principally as a cathartic. It is 
given in tablets or as a dry powder on the tongue. 

Blue Mass 0.1-0.5 gm. grs. ii-viii 

(Massa Hydrargyri) 

This is mercury rubbed with glycerin, honey, licorice, 
althaea, etc., and contains 33i% of mercury. It is used 
principally as a cathartic, in the form of pills; each pill con- 
taining 0.2-0.3 gm. (grs iii-v) of blue mass. 

Mercury with Chalk 0.12-0.5 gm. grs. ii-viii 

Gray Powder 
(Hydrargyrum cum Creta) 

This is a gray powder made like blue mass, but it con- 
tains chalk in addition to the other ingredients. It is used 
as a mild cathartic. 

Yellow Iodide of Mercury 0.008-0.06 gm. gr. J-i 

Protoiodide of Mercury 
(Hydrargyri Iodidum Flavum) 

Red Iodide of Mercury 0.0012-0.006 gm. gr. ^VrV 

Biniodide of Mercury 
(Hydrargyri Iodidum Rubrum) 

Solution of Arsenic and Mercuric 

Iodides 0.3-1.3 c.c. m. v-xx 

(Liquor Arseni et Hydrargyri Iodidi) 

(Donovan's Solution) 

This contains 1% each of arsenic iodide and the red mer- 
curic iodide. 

For Local Use 

Mercurial Ointment 
Blue Ointment 
(Unguentum Hydrargyri) 

This is made by thoroughly rubbing together mercury, 
oleate of mercury, lard and suet. It is used principally for 
inunctions. 

Ointment of Yellow Mercuric Oxide 
(Unguentum Hydrargyri Oxidi Flavi) 

This contains 10% of yellow oxide of mercury. 



486 MATERIA MEDICA 

Ointment of Red Mercuric Oxide 
(Unguentum Hydrargyri Oxidi Rubri) 

This contains 10% of red oxide of mercury. 

Ointment of Ammoniated Mercury 
(Unguentum Hydrargyri Ammoniati) 

This contains 10% of ammoniated mercury. 

Ointment of Mercuric Nitrate 
(Unguentum Hydrargyri Nitratis) 
Citrine Ointment 

This contains 7% of mercuric nitrate. 

New and Non-official Preparations 

Black Wash 

(Lotio Hydrargyri Nigra) 

This consists of 4.0 gms. (3 i) of calomel to 500 c.c.(l pt.) 
of lime water. It is used principally as an external appli- 
cation. 

Yellow Wash 

(Lotio Hydrargyri Flava) 

This consists of corrosive sublimate 2.0 gms. (5j) to 
500 c.c. (1 pt.) of lime water. It is used principally as a 
local application. 

Mercuric Cyanide 0.004-0.008 gm. grs. T V~i 

(Hydrargyri Cyanidum) 

It is also used as a local antiseptic in solutions of 1-4000 
to 1-2000. It does not blacken instruments. 

Mercury Oxy cyanide 
(Hydrargyri Oxycyanidum) 

This is used like bichloride of mercury. It has a greater 
antiseptic power, is less injurious to the tissues, and does not 
corrode instruments. It is used in 1-5000 solutions. 

Mercuric Salicylate 0.003-0.008 gm. gr. 2W 

(Hydrargyri Salicylas) 

This preparation is now frequently used, especially for 
intramuscular injections. For these injections, a 10% solu- 



SPECIFICS 487 

tion in water or liquid paraffin is used, of which 0.6 c. c. (m. x) 
is injected deep into the gluteal muscles every fourth day. 

Mercuric Succinimide 0.01-0.015 gm. gr. J-J- 

(Hydrargyri Succinimidum) 

This is used principally for intramuscular injections. A 
2\% solution is used, of which 0.5-1.0 c.c. (m. viii-xv) are 
injected daily. 

It also comes in hypodermic tablets, each containing 
0.006-0.003 (gr. T WV). 

Mercurol 0.03-0.12 gm. grs. |-n 

(Hydrargyri Nucleinas) 

This is said to have a special value as an antiseptic and 
specific for syphilis. 

Mergal one capsule 0.015 gm. grs. J ii 

This is a mixture of mercuric cholate and albumin tannate 
put up in capsules. Each capsule contains 0.05 gm. (gr. f) 
of mercuric cholate. 

Mercuric Benzoate 0.015-0.03 gm. gr. \- \ 

(Hydrargyri Benzoas) 

This has been used principally as a specific for syphilis 
and is given hypodermically. 

Calomelol 

Colloidal Calomel 

(Hydrargyri Chloridum Mite Colloidale) 

Calomelol is a preparation of calomel combined with al- 
buminoids, and is said to act more efficiently, not to gripe 
as much, and to be less poisonous than calomel. 

THE IODIDES 

The iodides are salts formed by the action of an alkali, 
such as sodium, potassium or ammonium, on hydriodic 
acid, an acid formed from iodine; a non-metallic element, 
obtained from sea-weeds. 

Appearance of the Patient 
After a single dose of one of the iodide salts is given, ex- 



488 MATERIA MEDICA 

cept for its slightly metallic salty taste, a slight burning 
pain in the stomach, and perhaps some slight nausea for a 
few minutes, there are no appreciable effects. 

If the iodides are given continuously for some time, how- 
ever, the secretions are all increased, the pulse is somewhat 
faster and softer, the patient passes more urine and feels 
much better. 

When the iodide preparations are given for some time to a 
patient suffering from any manifestation of syphilis, espe- 
cially of the third stage, these symptoms gradually disappear, 
and the patient feels entirely well again, in a very short 
time. For example, if the patient has a syphilitic ulcer in 
any region of the body, the ulcer gradually heals. A syphi- 
litic paralysis when treated with an iodide preparation, soon 
disappears, and the patient can move the paralyzed extrem- 
ity perfectly well again. 

ACTION 

Local action. The iodides produce no local effect when 
applied on the skin or mucous membranes, but they are 
rapidly absorbed into the blood from all mucous membranes. 

Internal Action 

In the mouth: The iodides have a characteristic salty 
metallic taste. 

In the stomach: They slightly increase the secretions, 
and occasionally cause nausea, and slight discomfort. The 
intestines are not usually affected by the iodides. 

Action after Absorption 

The iodides are very rapidly absorbed into the blood; from 
the stomach, intestines, and all the mucous membranes, 
usually in about five minutes. After absorption, it acts 
principally as a specific for syphilis, and it also affects the 
secretions, the kidneys, newly formed tissues, and the nutri- 
tion. 

Specific Action in Syphilis 

The most striking effect of the iodides is noticed in pa- 



SPECIFICS 489 

tients suffering from syphilis, especially from the symptoms 
of the third stage. These symptoms are the result of the 
formation of areas of round cells (gummata) which form in 
various parts of the body as a result of the presence in the 
blood of the spirochaeta pallida. These newly formed areas 
of cells very soon become fluid and areas of various tissues 
and organs of the body are thus destroyed, thus producing 
various symptoms. 

Very soon after the treatment with the iodides is begun 
in these patients, the patient feels better, the particular 
manifestation of syphilis from which he may be suffering, 
begins to improve, until finally he is entirely well again. 
For example, if the patient is suffering from a syphilitic 
ulcer in any part of the body, after treatment with iodides 
this ulcer heals very rapidly. A syphilitic paralysis due to 
the formation of a gumma in the brain or spinal cord, when 
treated with iodides soon disappears. The affected extremi- 
ties regain their motion and the patient soon feels entirely 
well again. In a similar manner, a syphilitic condition of 
any organ of the body is relieved. The iodides cure the 
third stage of syphilis, by causing the absorption of newly 
formed areas of round cells, or gummata, which cause the 
various symptoms. It also probably destroys the spiro- 
chaetae which cause the disease. 

Action on the secretions: The iodides increase the secre- 
tions of all the mucous membranes and the salivary glands. 
The mucous from the nose and bronchi is particularly in- 
creased, and becomes more fluid in character. The secretion 
of saliva, milk, and other glands are also slightly increased. 

Action on the kidney: The iodides slightly increase the 
flow of urine. 

Action on nutrition: They increase the nutrition of the 
tissues and hasten the excretion of waste products. 

Effect on newly formed tissues: The iodides increase the 
absorption of newly formed connective tissue, and even old 
scar tissue in any organ of the body. These drugs are 
frequently used for these effects in arteriosclerosis (Harden- 
ing of the arteries), cirrhosis of the liver, etc. 

Young connective tissue cells are small round cells which 



490 MATERIA MEDICA 

resemble the round cells found in gummata, and they are 
therefore probably affected by the iodides in the same way 
as the gummata or round cell formations of the third stage 
of syphilis. Accumulations of serum in the chest (pleurisy 
with effusion) or in other parts of the body, is more rapidly 
absorbed when the iodides are given. 

Action on the heart: The pulse is often faster after con- 
tinued use of the iodides. 

Excretion 

The iodides are eliminated from the body by the urine, 
mainly as iodides, usually within twenty-four hours. The 
iodine is also separated from the iodides, and this is then 
excreted in all the secretions of the secretory glands and 
mucous membranes. The mucous of the nose and the bron- 
chi, the saliva, milk, the hair, etc., then contain iodine, 
which also increases these various secretions. 

Idiosyncrasies 

In some individuals small doses often cause poisonous 
effects. 

Poisonous Effects 

The iodides do not cause acute poisoning. Since they are 
excreted more slowly than they are absorbed, however, 
chronic poisoning or iodism frequently results from the 
accumulation of some of the drug in the body after prolonged 
administration. These cumulative symptoms occasionally 
result in some individuals from very small doses. 

The symptoms of iodism are due to the excretion of the 
iodine by the various mucous membranes, and they are not 
so apt to occur in syphilitic patients. 

Cumulative Symptoms or " Iodism " 

The first symptom of excessive iodide action is: 

1. Profuse secretion of mucus from the nose (coryza) and 
sneezing. 

These are soon followed by: 

2. Red, swollen eyelids with excessive flow of tears. 



SPECIFICS 491 

3. Frontal headache. 

4. Cough, with profuse expectoration of mucous. 

5. Increased flow of saliva. 

6. Sore throat and difficulty in swallowing. 

7. Skin eruptions, such as areas of redness, or small 
pustules on the face, back, shoulders or thigh (acne). Oc- 
casionally eczema occurs. 

8. The pulse is often rapid and a slight rise in temperature 
may occur. 

9. Nausea, and diarrhoea occasionally occur. 

10. Weakness, loss of weight, and pains in the joints oc- 
casionally result from continued use. 

Treatment 

When the iodides are stopped, the symptoms usually 
disappear. 

Uses 

The iodides are used principally: 

1. As a specific for the third stage of syphilis. In syphilis, 
the treatment must be continued for about three years; 
even if the patient has no symptoms, to eradicate all the 
poison from the body. 

2. They are also frequently used to absorb connective 
tissue in various chronic diseases characterized by the for- 
mation of connective tissue in various organs and tissues of 
the body. For example, in arteriosclerosis (thickening of 
the blood vessels by the formation of connective tissue in 
their walls), cirrhosis of the liver, or the formation of con- 
nective tissue in the liver, chronic nephritis or the forma- 
tion of connective tissue in the kidneys, etc. 

3. To increase the absorption of inflammatory swellings 
of the glands and other tissues, and to absorb fluids in the 
chest. 

4. To increase the secretions of the mucous membranes, 
such as the bronchi, the nose, etc. 

Administration 

The iodides are best given before meals; in milk, wine, 



492 MATERIA MEDICA 

aromatic spirits of ammonia, or the compound spirits of 
sarsaparilla, or cinnamon water, to disguise the unpleasant 
taste. It is occasionally given in pills or capsules. 

Preparations 

Potassium Iodide 0.3-1.0 gm. grs. v-xv 

(Potassii Iodidum) In syphilis it may be given up to 4.0 gms. (5i) 

This is the most efficient and most commonly used prepa- 
ration. It often comes in 50% or saturated (100%) solutions. 

Sodium Iodide 0.12-1.3 gm. grs. ii-xx 

(Sodii Iodidum) 

Ammonium Iodide 0.12-1.0 gm. grs. ii-xv 

(Ammonii Iodidum) 

Strontium Iodide 0.3-1.0 gm. grs. v-xv 

(Strontii Iodidum) 

Dilute Hydriodic Acid 0.3-0.6 c.c. m. v-x 

(Acidum Hydriodicum Dilutum) 

This contains 10% of hydriodic acid. 

Syrup of Hydriodic Acid 2.0-8.0 c.c. 5i~ii 

(Syrupus Acidi Hydriodici) 

This contains 1% of hydriodic acid. 

For Local Use 

Potassium Iodide Ointment 
(Unguentum Potassii Iodidi) 

New and Non-official Preparations 

Sajodin 1.0-3.0 gms. grs. xv-xlv 

This acts like potassium iodide, but is said not to produce 
the symptoms of iodism. 

Ferro Sajodin 1-2 tablets 

This contains 5% of iron and 24% of iodine. It comes in 
tablets, each containing 0.5 gm. (grs. viii) of ferro sajodin. 

Iodo Casein 0.3-1.3 gm. grs. v-xx 

It is digested in the intestine where it is rapidly absorbed, 



SPECIFICS 493 

then acting like the iodides. It does not disturb digestion as 
much as the other iodides. 

Iodalbin 0.3-0.6 gm. grs. v-x 

This is a compound of iodine and albumin from blood. 
It is absorbed from the intestines, and it then acts like the 
other iodides. 

Iodipin 0.2-0.6 gm. grs. ii-x 

This is a compound of iodine and sesame oil. It acts like 
the other iodides, but its effects are more lasting, and they 
are said not to cause iodism. It is given hypodermically. 
It usually comes in 10 or 25% solutions or in capsules, each 
containing 2.0 gms. (grs. xxx). 

Iothion 

This acts like the iodides or iodine, and is readily ab- 
sorbed from the skin. It is applied in a 25 to 50% ointment 
like mercury ointment. 

SALVARSAN 

Salvarsan, arsenobenzol, or " 606 " is a complex organic 
arsenic salt. It is a yellow powder which comes in a sealed 
glass tube together with nitrogen gas. 

ACTION 

Salvarsan is a specific against all stages of syphilis. It 
cures this disease by destroying the organism which causes 
syphilis; the spirochaeta pallida, and its poisons. The 
results obtained from the use of salvarsan are very remark- 
able; the symptoms often clearing up entirely in a few weeks. 

Since this treatment has only been used for a few years, 
however, and, as the symptoms of the third stage of syphilis 
often return as long as twenty years after the infection, it is 
impossible to state at the present time whether the cure is 
permanent or not. 

The treatment with salvarsan is frequently repeated a 
number of times, and is usually followed by the usual 
treatment with mercury and iodides. 

Salvarsan has also been used with success in the treatment 
of malaria, and other infectious diseases resulting from the 



L 



494 MATERIA MEDICA 

circulation in the blood of a parasitic organism, such as the 
organism of relapsing fever, frambesia, etc. 

Symptoms of arsenic poisoning occasionally result from 
the use of salvarsan. 

Administration 

Salvarsan is usually given by direct injection into the 
veins, like an intravenous infusion. The remedy must be 
very carefully neutralized with an alkali, such as potassium 
hydroxide, and then dissolved in about 250-300 c.c. of 
sterile, distilled water, and the resulting solution is then 
allowed to slowly run into the veins. 

Salvarsan is also given by deep injections into the muscles. 

Preparations 

Salvarsan or " 606 " 0.3-0.6 gm. grs. v-x 

Arsenphenol-amin hydrochloride 
(Arsenobenzol) 

This contains about 31% of arsenic. 

Neosalvarsan 0.6-0.9 gm. grs. x-xiv 

Neosalvarsan is only half as strong as salvarsan. It has 
the advantage that it does not have to be neutralized with 
an alkali. It is dissolved in sterile, distilled water; about 
25 c.c. being used for every 0.1 gm. of neosalvarsan. 

It is given like salvarsan, by injection into the veins 
(intravenously), or it is injected into the muscles (intra- 
muscularly). 

SALICYLIC ACID AND THE SALICYLATES 

Salicylic acid is a white crystalline powder which is made 
chemically by the action of sodium hydroxide (caustic 
soda) and carbonic acid, on carbolic acid. 

The salicylates are salts formed by the combination of an 
alkali, such as sodium, with salicylic acid; sodium salicylate 
being thus formed. Various other salts are made in a similar 
way, by the combination of an organic chemical substance 
such as methyl alcohol with salicylic acid, methyl salicylate 
then being formed. 



SPECIFICS 495 

Many of these salts are found in various plants. For 
example, methyl salicylate is found in the oil of wintergreen, 
or oleum gualtheriae, and in the oil of sweet birch, oleum 
betulae. 

There are many new preparations which are made chemi- 
cally from salicylic acid or its salts. Many of these are 
extensively used. 

Appearance of the Patient 

About 15 minutes after an average dose of salicylic acid, 
or one of the salicylates is given, the patient complains of a 
slight burning pain in the pit of the stomach, and possibly of 
a slight feeling of fullness in the head. Soon the patient 
sweats profusely, and the temperature is lowered 1 or 2 
degrees, particularly if there is fever. The pulse is somewhat 
faster and stronger, unless the dose given has been quite 
large, but it may be slower and weaker. The breathing is 
usually somewhat faster, and the patient passes more urine. 

If the patient is suffering from acute articular rheumatism, 
the pains and swellings around the joints are gradually 
relieved. 

ACTION 

Local action: Salicylic acid and the salicylates are anti- 
septics. They soften the epidermis or hard layer of the skin 
when directly applied to the surface. On mucous mem- 
branes, they cause redness and increased secretions (irrita- 
tion) . 

Internal Action 

In the mouth : They have a peculiar salty sour taste. 

In the stomach: Salicylic acid and the salicylates increase 
the secretions, but they lessen digestion, by diminishing the 
activity of the digestive ferments, such as pepsin. If given 
on an empty stomach, they are apt to cause burning pain in 
the stomach, occasionally nausea, and possibly vomiting. 

In the intestines : They have an antiseptic action, checking 
the growth of bacteria. At the same time, they increase the 
secretions and lessen digestion. 



496 MATERIA MEDICA 

Action after Absorption 

Salicylic acid and the salicylates are rapidly absorbed in 
the stomach and intestines, usually in about 15 minutes. 
After absorption, they affect the circulation, the respiration, 
the sweat glands, the kidneys, the temperature and they 
affect particularly acute articular rheumatism. 

Action on the circulation : The salicylates usually make the 
pulse somewhat faster and stronger at first, by increasing 
the contractions of the heart muscles and contracting the 
blood vessels. 

With larger doses, the contractions of the heart muscle are 
soon weakened and the pulse becomes slower and weaker. 

The blood vessels of the skin are usually dilated, so that 
the skin is flushed. 

Action on the respiration: The breathing is usually some- 
what faster and deeper after salicylates, occasionally the 
patient is somewhat short of breath (dyspnoeic). 

Action on the secretions: The salicylates increase partic- 
ularly the secretion of sweat. The patient is usually covered 
with profuse perspiration, about fifteen minutes to a half 
hour after a dose of one of the salicylates is given. They are 
also said to increase the flow of bile. 

Action on the kidneys: The salicylates increase the se- 
cretion of urine; they also act as an antiseptic along the 
urinary organs, and make the urine more acid in reaction. 
The urine occasionally contains albumin. 

Effect on temperature: The salicylates reduce the tempera- 
ture several degrees in fevers, because of the increased elimina- 
tion of heat which results from the profuse sweating and 
dilated blood vessels of the skin. The temperature begins 
to go down in fifteen minutes, and stays down for about 
six hours. The normal temperature is not affected however. 

Specific Action in Rheumatism 

Salicylic acid and the salicylates are used principally as 
specifics for acute articular rheumatism. 

Acute articular rheumatism is a disease characterized by 
pain, redness and swelling of the various joints of the body, 



SPECIFICS 497 

associated with high temperature. The disease begins in 
one joint, and then affects many of the others. The cause 
of this disease is unknown, though it is probably an infec- 
tious disease. 

Effect of Salicylates 

When any of the salicylates are given regularly for some 
time, to a patient suffering with acute articular rheumatism, 
the pains become lessened in a few days, the redness and 
swelling of the joints are diminished, the temperature sub- 
sides, and the patient soon gets well. 

The mode of its action is unknown. Many cases, however, 
are improved better by some preparations of the salicylates 
than by others, and some cases are not improved at all by 
any of them. Chronic rheumatism, however, does not 
respond so readily to treatment with the salicylates. 

Excretion 

The salicylates are eliminated from the body as salicyluric 
acid, mainly by the urine, usually in several hours. Some of 
the drug is also excreted in the perspiration, milk and bile. 

Poisonous Effects 

Large doses of salicylates often cause quite alarming 
symptoms, especially if used for a long time, but they are 
rarely fatal. The symptoms resemble those of quinine 
poisoning. 

Symptoms 

The first symptom of an overdose of salicylates is : 

1. Buzzing and noises in the ears, and a feeling of fullness in 
the head. These are soon followed by: 

2. Deafness. 

3. Dimness of vision. 

4. Profuse perspiration. 

5. Feeling of warmth all over the body. 

6. Occasionally nausea and vomiting. 

In severe cases besides these symptoms there are usually : 

7. Dyspnoea, rapid, irregular, deep and labored breathing. 



498 MATERIA MEDICA 

8. Collapse (slow, weak pulse, subnormal temperature, 
cold moist skin, etc.). 

9. Unconsciousness. 

10. Occasionally the patient becomes delirious or even 
maniacal, and he often seems to see various objects about, 
him (hallucinations of sight) or he may hear voices about 
him (hallucinations of hearing). 

Death has rarely resulted from salicylate poisoning. 

Treatment 

1. If the drug is stopped, the symptoms usually disappear 
in a few days or a week. 

2. Caffeine, strychnine, or other heart stimulants should 
be given, if the pulse is weak. 

Administration 

Salicylic acid or the salicylates, are best given in capsules, 
tablets or in syrup, about an hour or two after meals. They 
will not then interfere with digestion, and are not so apt to 
cause nausea and pain in the stomach. 

Preparations 
Salicylic Acid 0.3-2.0 gms. grs. v-xxx 

(Acidum Salicylicum) 

This is more readily dissolved in hot water or in a solution 
of boric acid or borax. 

Sodium Salicylate 0.3-2.0 gms. grs. v-xxx 

(Sodii Salicylas) 

This is more soluble than the salicylic acid and is not so 
apt to upset the stomach. 

Lithium Salicylate 0.3-2.0 gms. grs. v-xxx 

(Lithii Salicylas) 

Ammonium Salicylate 0.3- gm. grs. v 

(Ammonii Salicylas) 

Strontium Salicylate 1.0- gm. grs. xv 

(Strontii Salicylas) 

Oil of Wintergreen 0.3-1.0 c.c. m. v-xv 

(Oleum Gaultheriae) 



SPECIFICS 499 

This is a volatile oil obtained by distilling Gaultheria 
procumbens or wintergreen. It contains 90% of methyl 
salicylate and is given in emulsion or capsules. It acts like 
the salicylates, but it occasionally causes nausea and vomit- 
ing. 

Oil of Sweet Birch 0.3-1.0 c.c. m. v-xv 

(Oleum Betulae) 

This is made by distilling the bark of Betula lenta or 
birch bark. 

Methyl Salicylate 0.3-1.0 gm. grs. v-xv 

(Methylis Salicylas) 

This is artificial oil of wintergreen. It is contained in oil 
of wintergreen and oil of sweet birch. 

Salicin 0.3-2.0 gms. grs. v-xxx 

(Salicinum) 

Salicin is a glucoside obtained from the bark of various 
species of willow and poplar trees. It is changed to salicylic 
acid in the body and it then produces the same effects. 

It has a very bitter taste and is not as reliable in its action 
as the other preparations. 

Salol 0.3-2.0 gms. grs. v-xxx 

(Phenylis Salicylas) 

Salol is a tasteless powder which is decomposed by the 
steapsin of the pancreatic juice in the intestine into salicylic 
and carbolic acids. The salicylic acid is absorbed into the 
blood from the intestines, and it then produces the same 
effects as salicylic acid. 

Salol is frequently used as an intestinal and urinary an- 
tiseptic. Symptoms of carbolic acid poisoning frequently 
result from the carbolic acid which it forms in the intestines. 

For Local Use 
Boro Salicyl Solution 

(Thiersch Solution) 

This is a solution made by dissolving a Thiersch powder 
in 1000 c.c. or a quart of water. 
Each Thiersch powder contains: 



TABLE OF COMPARATIVE ACTION OF SALICYLATES 



Name of 
Drug 


Local 
Action 


Anti- 
septic 
Action 


Effect on 
Stomach 


Rate of 
Absorp- 
tion 


Effect on 
Sweat 
Glands 


Effect 
on Tem- 
perature 


Poisonous 
Effects 


Salicylic 
acid. 


Softens 
skin. 


Local 
intestinal 

and 
urinary- 
antisep- 
tic. 


Occasional 
nausea. 


Rapid. 


Profuse 
perspira- 
tion. 


Lowered. 


Slow weak 

pulse, 

ringing in 

the ears, 

etc. 


Sodium 
Salicylate 
Strontium 
and 

Lithium 
salicy- 
lates. 


Does not 

soften 

skin. 


No local 
antisep- 
tic action 
but is a 
urinary 
and in- 
testinal 
antisep- 
tic. 


Nausea 
less com- 
mon. 


Rapid. 


Same. 


Same. 


Same. 


Methyl 
salicylate 
and Oil of 
winter- 
green. 


No effect 
on skin. 


Same. 


More 
nausea. 


Same. 


Same. 


Same. 


Same. 


Salol. 


Same. 


Same. 


No effect 

in the 
stomach. 


Slow- 
ly ab- 
sorbed 
in the 
intes- 
tine 
forms 
carbolic 
and sal- 
icylic 
acid. 


Same. 


Same. 


Carbolic 

acid 
poisoning 
occasion- 
ally. 


Salicin. 


Same. 


Slight in- 
testinal 

and 
urinary 
antisep- 
tic. 


Same. 


Slow- 
ly ab- 
sorbed 
in intes- 
tine. 
Effect 
slow 
and not 
as reli- 
able. 


Same. 


Same. 


Poisoning 
rare, slow 
pulse ring- 
ing in the 
ears. 


Aspirin 
Novaspi- 
rin and 
newer 
drugs. 


Same. 


Intesti- 
nal anti- 
septic. 


Occasional 

burning 

pain and 

nausea. 


Slow 
absorp- 
tion. 


Same. 


Same. 


Poisonous 
effects are 
occasional 
slow pulse. 



500 



SPECIFICS 501 

Boric Acid 15.0-30.0 gms. 5j-i 

Salicylic Acid 2.0- 4.0 gms. 3j-i 

Thiersch solution is used as an antiseptic dressing, and is 
particularly valuable to soften the skin. 

Salicylic Acid Ointments: 

These usually contain from 2 to 20% of salicylic acid and 
are principally used to soften and remove corns. Many 
corn salves and plasters consist principally of salicylic acid. 

New and Non-official Preparations 

Aspirin 0.3-1.0 gm. grs. v-xv 

(Acidum Acetylsalicylicum) 

This is a compound made chemically from salicylic acid. 
It is absorbed in the intestines and then acts like salicylic 
acid, but because it is very slowly absorbed, its effects are 
more lasting. It is not so apt to cause poisonous effects. 

Novaspirin 0.3-1.0 gm. grs. v-xv 

(Methylene Citrylsalicylic Acid) 

It acts like aspirin but is said not to upset the stomach. 

Diaspirin 1.0 gm. grs. xv 

Succinyl Disalicylic Acid 

Ethyl Salicylate 0.3-0.6 c.c. m. v-x 

(Aethylis Salicylas) 

(Sal Ethyl) 

This is similar to methyl salicylate, and is said not to cause 
poisonous symptoms. 

Mesotan or Ericin 

This is an oily fluid made from salicylic acid (methyl 
oxymethyl salicylate). It acts like the oil of wintergreen 
and is applied to the skin in an equal part of olive oil. 

Salophen 0.3-1.0 gm. grs. v-xv 

This resembles salol in its action. It is changed in the in- 
testines to salicylic acid, and acetylparamidophenol, which is 
not poisonous. It is therefore safer than salol. 

Saloquinine 0.5-2.0 gms. grs. viii-xxx 



These are preparations which act like salol. 



502 MATERIA MEDICA 

This is a compound of quinine and salicylic acid; quinine 
salicylate. It combines the action of both. 

Saloquinine Salicylate 1.0 gm. grs. xv 

This acts like saloquinine. 

Spirosal 

Monoglycol Salicylate 

This is absorbed from the skin and acts like salicylic 
acid which it forms in the body. It is applied on the skin 
in three parts of alcohol or in eight parts of olive oil. 

Betol or Naphthol 
Naphtholis Salicylas 

Cresol (official) 
Thymosalol 

Antipyrine salicylate, phenocoll salicylate, saliphen, mala- 
kine, are used mostly to reduce fever, though they also act 
like salicylic acid which they form in the body. (See anti- 
pyretics.) See also Table, page 500. 

COLCHICUM (MEADOW SAFFRON) 

Colchicum is obtained from the seeds, Colchici semen and 
underground stems, Colchici cormus, of the meadow saffron 
or Colchicum autumnale, a small plant growing in Europe 
and England. The active principle is a substance called 
colchicine. 

Appearance of the Patient 

An ordinary dose of colchicum causes very little effect, 
but several hours after a moderate dose is given, the patient 
complains of some abdominal pain, perhaps of a little nausea, 
and later he has frequent movements of the bowels and the 
urine may be somewhat increased. The pulse may be a 
little slower and occasionally the tears, saliva and sweat are 
somewhat increased. 

If the patient is suffering from an attack of acute gout, 
the severe pains of this condition are usually relieved. 

ACTION 
Local action: Applied to the skin or mucous membranes, 



SPECIFICS 503 

it causes redness, burning pains and swelling, with increased 
secretions of the mucous membranes. 

Internal Action 

In the mouth: Colchicum causes burning pains. It in- 
creases the secretion of saliva and also causes pain in the 
throat. 

In the stomach and intestines: It increases the secretions 
and peristalsis, occasionally causing nausea and frequent 
movements of the bowels. It often causes cramp-like abdom- 
inal pains. 

Action after Absorption 

Colchicum is very slowly absorbed from the stomach and 
intestines, usually in about several hours. After absorption 
it affects particularly the pains of acute gout and the kidneys. 

Action in Gout 

Acute gout is a disease characterized by severe pain, red- 
ness and swelling of one or more joints of the body. The 
joints of the toes and hands are particularly affected, and 
the pains more often occur at night. The disease is said to 
be due to the deposit in the joints, of crystals of uric acid, 
one of the constituents of the urine. 

Colchicum relieves particularly the pains of acute gout, though 
it is not really a specific for that disease. 

Action on the kidney: Colchicum increases the secretion 
of urine. It is said to increase the amount of uric acid and 
urea in the urine. 

Action on the secretions: Large doses of colchicum in- 
crease the secretions of saliva, tears, mucus from the nose 
and from all the other mucous membranes. Large doses oc- 
casionally make the pulse and breathing somewhat slower. 

Excretion 

Colchicum is eliminated from the body in a few hours; by 
the kidney, the stomach and intestines. 

Poisonous Effects 
Colchicum is a very violent poison; small doses having 



504 MATERIA MEDICA 

caused death. An overdose of colchicum usually causes the 
following symptoms within a few hours: 

1. Severe abdominal pain. 

2. Nausea, and continual profuse vomiting which is ac- 
companied by profuse secretion of saliva, tears and mucus 
from the nose. 

3. Profuse diarrhoea. 

The vomited matter and stools contain mucus and serum 
at first, but later they often contain blood. 

4. Scanty and bloody urine, or there may be no urine 
secreted at all. Occasionally the urine may be increased. 

5. Spasms of the muscles, even convulsions followed by 
great muscular weakness, with slow movements and paraly- 
sis. 

6. Collapse (rapid, thready pulse, slow and shallow breath- 
ing, cold moist skin). 

Death soon results from respiratory paralysis. 

Treatment 

1. Give tannic acid preparations, to neutralize the col- 
chicum. 

2. Wash out the stomach. 

3. Protect the mucous membrane by white of egg, milk, 
etc. (demulcents). 

4. Keep the patient quiet. 

5. Treat the collapse with heart stimulants, such as caf- 
feine, strychnine, etc. 

Uses 

Colchicum is used principally to relieve the pains of acute 
gout. It is also given together with potassium iodide in 
chronic rheumatism. 

Preparations 

Colchicum Stems 
Extract of Colchicum Stems 0.03-0.12 gm. grs. §-ii 
(Extractum Colchici Cormi) 

Colchicum Seeds 
The preparations of the seeds are principally used. 



SPECIFICS 505 

Wine of Colchicum Seeds 0.6^.0 c.c. m. x-5i 

(Vinum Colchici Seminis) 

This contains 10% of colchicum and is the preparation 
commonly used. 

Fluidextract of Colchicum Seeds 0.1-0.3 c.c. m. ii-v 
(Fluidextractum Colchici Seminis) 

Tincture of Colchicum Seeds 0.3-1.0 c.c. m. v-xv 

(Tinctura Colchici Seminis) 

Colchicine (the active principle) 0.0005 gm. gr. T ^ 

PIPERAZINE (not official) 

Piperazine is a chemical substance which is frequently- 
used to relieve gout, and to dissolve stones in the kidney 
and bladder. Its use is based upon the fact that it dissolves 
uric acid crystals, when added to them in a test tube. Prac- 
tical experience in the use of this drug has not borne out this 
effect on the patient. It slightly increases the flow of urine, 
however. 

Preparations 

Piperazine 0.3-0.6 gm. grs. v-x 

(Piperazina) 

Lycetol 1.0-2.0 gms. grs. xv-xxx 

Dimethyl Piperazine Tartarate 

Sidonal or Piperazine Quinnate 1.0-1.3 gm. grs. xv-xx 

(Piperazinae Quinnas) 

ATOPHAN (not official) 

Atophan or phenylquinolin carboxylic acid, is a white, 
crystalline substance which is made chemically from various 
other complex substances. 

ACTION 

Atophan has a specific action in acute gout. It relieves the 
pains around the joints very promptly. It increases the secre- 
tion of urine and the amount of uric acid contained in it. 
Beneficial effects have also been obtained from its use in 
other chronic joint affections, such as rheumatism, etc. 



506 MATERIA MEDICA 

It is not a poisonous drug, and is therefore safer than col- 
chicum. 

Preparations 

Atophan 0.5-1.0 gm. grs. viii-xv 

Phenyl-qulnolin Carboxylic Acid 

Novatophan 0.5-1.0 gm. grs. viii-xv 

Paratophan 0.5-1.0 gm. grs. viii-xv 









ANTHELMINTICS 

Anthelmintics are drugs which are principally used to 
destroy or expel intestinal worms. The drugs which destroy 
these worms are often called vermicides, and those which 
expel them, vermifuges. This difference in their action really 
depends however, upon the amount of the drug that is given, 
and how soon afterwards the bowels are moved. Thus, a 
large dose of one of the anthelmintics, if it remains in the 
intestine, will destroy the worm, while a smaller dose merely 
expels it. 

With the exception of pelletierine, which has a specific 
action on tape worms, most of these drugs do not affect 
the worms themselves. 

All the anthelmintics are poisonous both to the worm and 
to the patient, but they are very slowly absorbed, so that 
their poisonous action is manifested mainly on the worm. 
Occasionally, if these drugs are not followed by a cathartic, 
they may be absorbed, and poisonous symptoms then re- 
sult. 

The anthelmintics are best classified according to the 
particular worm for which they are used. 

The most common worms which are found in the intes- 
tines are: 

1. Tape Worms, or Taeniae. 

2. Round Worms, or Lumbrici. 

3. Thread Worms, Seat Worms or Ascarides. 

4. Hook Worms, or Uncinariae. 

The diagnosis of the form of worm is usually made by 
finding the particular eggs in the stools. 

Administration 

In giving any of the anthelmintics, it is important that 
the following routine measures be carefully carried out. 

1. The patient should be given a very light diet, a day or 
two before the drug is administered, or better still, no food 
should be given for twenty-four hours before. 

507 



508 MATERIA MEDICA 

2. The bowels should be thoroughly moved with a light 
laxative, the day before administration. 

3. The drug should best be given early in the morning 
on an empty stomach. 

4. About four to eight hours after the drug has been given, 
a brisk cathartic such as calomel, or castor oil, should be 
given, to expel the worm. Occasionally a cathartic like 
calomel is given together with the drug. It is best not to 
give the patient any food until the bowels move. 

TAENICIDES 

Taenicides are drugs which destroy or remove tape worms. 

Tape worms are long flat worms which consist of many 
segments. They often inhabit the intestine as a result of 
eating meat or pork infected with their eggs. 

MALE FERN (ASPIDIUM FILIX MAS) 

Male fern or filix mas is obtained from the underground 
stems of the Dryopteris filix mas and of Dryopteris marginalis, 
European ferns. 

The active principles of these plants are a number of 
neutral and acid substances; aspidin and numerous other 
similar substances, though filicic acid was formerly supposed 
to be the active principle. 

ACTION 

When taken internally, male fern has a very unpleasant, 
nauseous taste, and it destroys tape worms and hook worms. 

Poisonous Effects 

In some individuals, if large doses of the drug are given, 
it may be absorbed and cause: 

1. Abdominal pain. 

2. Nausea, vomiting and diarrhoea. 

3. Muscular twitchings. 

4. Convulsions, collapse, coma, and death. 



SPECIFICS 509 

Administration 

The oleoresin or liquid extract is usually given, either in 
pills, capsules or suspended in mucilage. 

Preparations 

Oleoresin of Aspidium 2.0-8.0 c.c. 5f-ii 

(Oleoresina Aspidii) 

New and Non-official Preparations 

Filicic Acid Amorphous 0.5-1.0 gm. grs. viii-xv 

(Acidum Filicicum Amorphum) 

Filmaron 10 c.c. 3ii? 

This is a substance obtained from an ethereal extract of 
aspidium. It is said to be safer than aspidium. 
This is a 10% solution of filmaron in castor oil. 

cusso 

Cusso, kousso or brayera, are the female flowers of Hagenia 
abyssinica or Brayera anthelmintica, an Abyssinian tree. Its 
active principle is a neutral resin, kosotoxin, but it also con- 
tains tannic acid, a volatile oil and other substances. 

ACTION 

Cusso has a bitter taste and contracts mucous membranes. 
Its principal effect is to destroy tape worms. 

Large doses occasionally cause nausea, vomiting, diarrhoea 
and rarely, collapse with an irregular pulse. 

Preparations 

Cusso is usually given by suspending 15.0 gms. (5i) of 
the powdered flowers in water. 

Fluidextract of Cusso (not official) 8.0-16.0 c.c. 3i-iv 

(Fluidextractum Cusso) 

No cathartic is required after cusso, though the usual 
preparatory methods should be carried out. 



510 MATERIA MEDICA 

GRANATUM (POMEGRANATE) 

Granatum is the bark of the stem and root of Punica 
granatum or pomegranate. Its active principles are the 
alkaloids, pelletierine or punicine, and isopunicine, and it 
also contains a large amount of tannic acid. 

ACTION 

Granatum and its alkaloids, have a specific destructive action 
on tape worms. It has a very unpleasant taste and is not a 
safe drug to use. 

Poisonous Effects 

Overdoses of pelletierine or granatum, paralyze the nerve 
endings of the muscles, causing effects like those of curara 
poisoning. 

Symptoms 

1. Mental dullness and confusion of ideas. 

2. Dizziness. 

3. Great weakness of the limbs, even paralyses. 

4. Dimness of vision. 

5. Occasionally nausea, abdominal pain, perhaps vomiting 
and tremors of the muscles of the legs. 

Administration 

Granatum is usually given as a decoction made from about 
30.0-60.0 gms. (Si— ii) of fresh bark, in about 250.0 c.c. (| pt.) 
of water. The drug is then given in two parts at intervals 
of an hour each, and the last dose should be followed in a 
half to two hours by a cathartic. 

Preparations 

Fluidextract of Pomegranate 2.0 c.c. m. xxx 

(Fluidextractum Granati) 

Pelletierine Tannate 0.25 gm. grs. iv 

(Pelletierinae Tannas) 

This is a mixture of all the alkaloids of pomegranate bark. 



SPECIFICS 511 

PEPO (PUMPKIN SEED) 

Pepo is the ripe seed of Cucurbita pepo or the ordinary 
pumpkin. Its active principle is a fixed oil and a resin. 

ACTION 

Pumpkin seeds are a very efficient and harmless remedy 
for tape worms. 

Administration 

The patient should fast the day before the drug is to be 
given, and the following morning, about two to four ounces 
of the seeds, beaten up in an emulsion of sugar and water, 
or honey, should be given. Occasionally, 15.0 gms. (5i) of 
the expressed oil is given. It should always be followed by a 
cathartic several hours later. 

Preparations 
Pepo or Pumpkin Seeds 60.0-120.0 gms. 5 ii-i v 

KAMALA 

Kamala is a reddish brown powder consisting of the 
minute glands and hairs from the capsules of Mallotus 
philippensis, an East Indian shrub. Its active principles are 
two resinoid substances, kamalin and rottlerin. 

ACTION 

Kamala destroys the tape worms and causes profuse di- 
arrhoea so that no cathartic is necessary after its use. 

Preparations 

About 4.0-8.0 gms. ( 5 i— ii) of the powder is given in syrup, 
and repeated in two hours if the bowels do not move. A 
tincture of kamala is also occasionally given. 

TURPENTINE 

Turpentine destroys tape worms and round worms. It is 
given in doses of 30.0 gms. (Si) with twice its amount of 



512 MATERIA MEDICA 

castor oil. It is also given in very small doses, together with 
other anthelmintics. It is very apt to cause poisonous 
symptoms and is therefore not frequently used. 

LUMBRICIDES 

Lumbricides are drugs which destroy round worms. 
Round worms are small cylindrical worms which are often 
found in the small intestine of children. 



SANTONICA (LEVANT WORM SEED) 

Santonica or levant worm seed is the dry unopened flower 
heads of the Artemisia pauciflora, a plant growing in Asia 
Minor. Its active principle is a crystalline substance called 
santonin, though it also contains a similar substance called 
artemisin and a volatile oil, cineol. 



ACTION 

Santonin has a bitter taste and is partly dissolved in the 
stomach. Here some of it is absorbed into the blood. Most 
of the santonin then passes out into the small intestine, where 
it destroys round worms, or ascaris lumbricoides. 

Action after Absorption 

The absorption of some of the santonin, causes in many 
cases, a very characteristic and peculiar disturbance of vision 
known as xanthopsia, or " yellow vision." 

At first all objects seem to have a blue color, but this ef- 
fect lasts for a very short time, and is soon followed by a con- 
dition where all objects seem to have a yellow tint; thus, blue 
seems green ; and violet cannot be seen at all. This condition 
lasts for several hours and is probably due to a direct poison- 
ous effect on the retina of the eye. Occasionally there are 
also disturbances of the sense of taste, smell, and hearing. 

Santonin is excreted by the urine, to which it gives a 
characteristic yellow or reddish color. 



SPECIFICS 513 

Poisonous Effects 

Overdoses of santonin not infrequently cause poisonous 
symptoms, especially in children. 

Symptoms 

1. " Yellow vision." 

2. Twitchings of the muscles of the head. 

3. Rolling of the eyes, and grinding of the teeth. 

4. Various movements of the head, forward and back- 
ward, and from side to side. These symptoms are soon 
followed by: 

5. Convulsions. 

6. Slow, irregular breathing, especially during the con- 
vulsions. 

7. Collapse (slow, weak pulse, moist cold skin, dilated 
pupils, etc.). 

8. Occasionally nausea and vomiting, or loss of speech 
(aphasia), occur. 

Treatment 

Wash out the stomach, give emetics and cathartics, and 
treat the convulsions with chloroform or ether. 

Preparations 

Santonin, the active principle, is the drug which is prin- 
cipally used. 

Santonin 0.03-0.3 gm. grs. J-v 

(Santoninum) 

For a child 2 years old 0.015 gm. (gr. i) should be given. 

Troches of Santonin 1-5 

(Trochisci Santoninae) 

For a child, only 1 should be given. 

Each contains 0.03 gm. (gr. \ ) of santonin. 

SPIGELIA (PINK ROOT) 

Spigelia or pink root is the root of the Spigelia marilandica, 
or Carolina pink, a plant growing in the southern United 

States. 



514 MATERIA MEDICA 



ACTION 



Spigelia is used to remove round worms. As it does not 
destroy the worm, it must be followed by a brisk cathartic. 

Poisonous Effects 

Overdoses of spigelia have occasionally produced • the 
following symptoms, especially in children. 

1. Dry, flushed skin. 

2. Puffiness and swelling of the face. 

3. Rapid pulse, delirium and stupor. 

4. Dimness of vision or temporary blindness. 

Preparations 

Fluidextract of Spigelia 4.0-8.0 c.c. 3i-ii 

(Fluidextractum Spigeliae) 

For a child, 0.6 c.c (m. x) is given on a piece of sugar. 
This is often given together with senna. 

AZEDARACH 

Azedarach is the bark of the root of Melia azedarach, 
or the pride of China, an Eastern plant. 

It is used in the South as a remedy for round worms. 
It is usually given as a decoction, made from §ii of the 
plant to a half pint of water, of which 15.0 c.c. or half ounce is 
given every two hours. It is said to produce the same 
poisonous effects as spigelia. 

CHENOPODIUM (not official) 

Chenopodium or American worm seed, is the fruit of the 
Chenopodium ambrosioides, or Jerusalem oak, an American 
plant. Its active principle is a volatile oil, which has an 
extremely rank odor. 

ACTION 

It is used principally to destroy round worms, and should 
always be followed by a brisk cathartic. 



SPECIFICS 515 

Preparations 

Oil of Chenopodium 0.2-0.3 c.c. m. iii-v 

(Oleum Chenopodii) 

It is usually given on sugar or in an emulsion. 
Senna and Calomel are also frequently used to remove 
round worms. 

DRUGS WHICH DESTROY THREAD WORMS 

Thread worms are small cylindrical worms which often 
inhabit the large intestine. The patients suffering from these 
worms are usually treated by enemata of the following sub- 
stances. 

1. Quassia 

2. Alum 

3. Sodium Chloride 

4. Tannic Acid 

5. Calumba 

6. Lime Water 

7. Vinegar 

DRUGS WHICH DESTROY HOOK WORMS 

Hook worms, uncinaria americana, or anchylostoma duode- 
nale, are small cylindrical worms which frequently inhabit 
the small intestine or duodenum. 

Many people in the Southern United States, Switzerland 
and Egypt suffer from these worms, which cause a very 
severe form of anaemia. 

The following drugs are used to destroy hook worms. 

THYMOL 

Thymol is a chemical substance which resembles carbolic 
acid or phenol, chemically. It is principally used as an 
antiseptic, but it also has a specific destructive action on 
hook worms. 

Administration 
The bowels are thoroughly moved with a brisk cathartic 



516 MATERIA MEDICA 

the day before, and the morning before administration, 
about 0.3-1.0 gm. (gr. v-xv) of thymol is given, and the dose 
is then repeated several times. About half an hour after the 
last dose, a dose of castor oil should be given. 

Calomel, naphthol and magnesium sulphate are also fre- 
quently used to destroy hook worms. 



PART V— DRUGS ACTING CHEMICALLY 

Drugs Which Produce Effects Merely by the Chemical 
Combinations Which They Form in the Body 

CHAPTER XX 

ACIDS AND ALKALIES 

ACIDS 

Acids are very sour substances, either fluid or solid, which 
consist of several chemical elements combined with hydro- 
gen. The hydrogen can be replaced by an alkali, thus form- 
ing a salt. 

The acids are divided into two groups; inorganic or mineral 
acids, and vegetable or organic acids. 

The vegetable or organic acids contain carbon as one of 
its elements, while the inorganic or mineral acids contain 
no carbon. 

Most of the acids are very poisonous substances and are 
only used in very dilute solutions. 

INORGANIC OR MINERAL ACIDS 

The mineral acids which are principally used, are hydro- 
chloric, sulphuric, nitric, nitrohydrochloric, and phosphoric 
acids. The inorganic acids produce practically the same 
effects with only slight individual differences. 

ACTION 

Local action: Applied to the skin, or mucous membranes, 
concentrated solutions of acids are very injurious to the 
tissues, and destroy the skin, mucous membranes and under- 
lying tissues. 

The tissues become shrunken, hard and brittle, because 

517 



518 MATERIA MEDICA 

the acids withdraw water from the tissues with which they 
come in contact. 

Dilute solutions of the acids usually contract mucous mem- 
branes. 

Internal Action 

In the mouth: The dilute solutions which are principally 
used, have a characteristic sour taste and relieve thirst. 
They increase the flow of saliva and contract the mucous 
membrane of the mouth. 

In the stomach: The acids aid the digestion of proteid or 
albuminous food, since the pepsin acts only in the presence of 
an acid, particularly hydrochloric acid. They slightly check 
the secretions of the mucous membranes, however, and are 
slightly antiseptic. 

In the intestines: If the acid enters the intestines, it is 
immediately neutralized by the alkaline juices which are 
always present there. Salts are thus formed, and at the same 
time the pylorus of the stomach immediately closes, to pre- 
vent more acid from entering the intestines. In a reflex 
manner, the acids increase the secretions of the pancreatic 
juice. 

Action after Absorption 

The acids are rapidly absorbed from the stomach, where 
they combine with the alkalis of the tissues to form salts; 
in which form they are absorbed into the blood. They then 
produce no effects, except to make the blood somewhat less 
alkaline in reaction. 

Excretion 

The acids are eliminated from the body by the urine, as 
acid salts; the alkalis of the salts being kept back in the blood. 
The urine is therefore more acid in character, and often 
slightly injures the kidney, and the urine may then contain 
albumin or blood. The patient may also have burning pain 
in the bladder when the urine is passed. 

Poisonous Effects 
Acute acid poisoning usually results from an acid taken 



ACIDS AND ALKALIES 519 

with suicidal intent. The poisonous effects of all the acids 
are the same, except that hydrochloric and nitric acids make 
the tissues yellow and hard, while sulphuric acid turns the 
tissues white in color and then brown. 

Symptoms 

1. Severe burning pain in the mouth, throat and stomach. 
The tissues about the mouth are dry, shrunken, white or 
yellow in color. 

2. Profuse vomiting. The vomited matter contains blood 
and pieces of mucous membrane. 

3. Profuse diarrhoea, the stools containing blood and pieces 
of mucous membrane. 

As a result of the destruction of the mucous membrane 
of the stomach and intestines, the patient suffers from; 

4. Profound collapse (rapid, thready, weak pulse, slow, 
shallow breathing, subnormal temperature). Death usually 
occurs in several hours. 

Occasionally the fumes of the acid may cause swelling 
of the larynx (oedema of the glottis), and the patient may 
then die of asphyxia. 

If the patient recovers, he may suffer from various symp- 
toms produced by the narrowing (stenosis) of the oesophagus, 
because of the scar tissue formed by the healing of the wound. 

Treatment 

1. Neutralize the acid with an alkali; such as magnesia, 
or magnesium carbonate, sodium bicarbonate, or lime water. 

If these substances cannot be obtained, chalk, plaster 
from the wall, soap suds, etc. may be used, and the acid 
should be well diluted by giving plenty of water. 

2. Protect the mucous membranes of the oesophagus and 
stomach by white of egg, milk, flour and water, etc. 

3. Treat the collapse with heart stimulants, such as 
caffeine, strychnine, atropine, etc., and keep the patient 
quiet. 

Do not wash out the stomach, as the stomach tube may 
pass through the injured stomach wall. 



520 MATERIA MEDICA 

Administration 

All the acids should be given before meals, well diluted, 
sipped very slowly through a glass tube, so as not to injure 
the teeth. 

PREPARATIONS OF THE MINERAL ACIDS 
DILUTE HYDROCHLORIC ACID 

Dilute hydrochloric acid is used principally to aid digestion 
in cases where there is an insufficient amount of hydrochloric 
acid secreted in the stomach; so that the pepsin is unable to 
digest the food. For example, in such diseases as chronic 
gastritis, or in infectious diseases. 

It is also used to lessen thirst, especially in fevers, and to 
check intestinal putrefaction and diarrhoea. 

Preparations 

Dilute Hydrochloric Acid 0.3-2.0 c.c. m. v-xxx 

(Acidum Hydrochloricum Dilutum) 

It contains 10% of hydrochloric acid. 

For local use 

Hydrochloric Acid 
(Acidum Hydrochloricum) 

This contains 31% of hydrochloric acid. 

Oxyntin (not official) 0.3-1.0 gm. grs. v-xv 

This is a compound of proteins and hydrochloric acid, 
and is used as a substitute for the latter substance in the 
digestion of proteids. It is only half as strong as dilute 
hydrochloric acid. 

SULPHURIC ACID (OIL OF VITRIOL) 

Sulphuric acid acts like the other acids, except that it 
checks intestinal secretions and the sweat. 

It is rarely used except as a remedy for lead poisoning 
and occasionally to check diarrhoea and night sweats. The 



ACIDS AND ALKALIES 521 

concentrated acid is occasionally used to destroy an infected 
area of the skin (caustic action). 

Preparations 

Dilute Sulphuric Acid 0.6-2.0 c.c. m. x-xxx 

(Acidum Sulphuricum Dilutum) 

This contains 10% of sulphuric acid. 

Aromatic Sulphuric Acid 0.3-1.0 c.c. m. v-xv 

(Acidum Sulphuricum Aromaticum) 

This contains 20% of sulphuric acid in alcohol, flavored 
with ginger and cinnamon. 

For Local Use 
Sulphuric Acid 
(Acidum Sulphuricum) 
(Oil of Vitriol) 

This contains 92% of sulphuric acid. 

NITRIC ACID (AQUA FORTIS) 

Nitric acid acts like other acids, except that it is said to 
increase intestinal secretions and the secretion of bile. 
It is occasionally used instead of hydrochloric acid to aid 
digestion. A drop of the strong acid is frequently applied 
on the skin to destroy an infected area of the skin. 

Dilute Nitric Acid 0.6-2.0 c.c. m. x-xxx 

(Acidum Nitricum Dilutum) 

This contains 10% of nitric acid. 

For Local Use: 
Nitric Acid 
(Acidum Nitricum) 

This contains 68% of nitric acid. 

NITROHYDROCHLORIC ACID 

Nitrohydrochloric acid or aqua regia, is a mixture of one 
part of nitric and 4 parts of hydrochloric acid. It is the 



522 MATERIA MEDICA 

most powerful acid, and the only fluid which will dissolve 
platinum and gold. 

This diluted acid is principally used to increase the flow 
of bile, given in the following ways: 

1. By mouth, sipped through a glass tube. 

2. In a foot bath or ordinary bath. 

3. It is said to be more efficient if it is applied to the liver 
in the form of a stupe, about 4.0-8.0 c.c. or 5i-ii of the 
dilute acid being used to a pint of water. 

Preparations 

Dilute Nitrohydrochloric Acid 0.3-1.0 c.c. m. v-xv 
(Acidum Nitrohydrochloricum Dilutum) 

This contains 40 parts of nitric acid and 180 parts of hydro- 
chloric acid in 1000 c.c. of water. 

Dilute phosphoric acid is principally used as a tonic. It 
does not destroy tissues like the other mineral acids. 

VEGETABLE OR ORGANIC ACIDS 

The vegetable or organic acids are obtained from various 
fruit juices such as the grapes, lemons, or by the prolonged 
fermentation of wines. 

Their effects are similar to those produced by the mineral 
acids, but they are milder. They do not produce poisonous 
effects, except when given in very large doses. 

The most common organic acids used are acetic, citric, 
and tartaric acids. 

The acetic acid is the most active one in the group, the 
others having a milder action. 

DILUTE ACETIC ACID 

Acetic acid is an organic acid formed by the prolonged 
fermentation of various fruits and vegetables. Thus, when 
wine is fermented for a long time, vinegar is formed, which 
consists mostly of acetic acid. 

ACTION 
Local action: Dilute acetic acid hardens and cools the skin; 



ACIDS AND ALKALIES 523 

it contracts the mucous membranes. It checks bleeding by- 
contracting the blood vessels. 

Concentrated solutions however, when locally applied, 
cause redness, pain, and the formation of a blister with 
slight destruction of the skin. 

Internal Action 

In the mouth: Dilute acetic acid has a very sour taste, 
it increases the flow of saliva, thereby lessening thirst. 

In the stomach: It increases the secretion of gastric juice, 
it improves the appetite, and aids digestion. 

In the intestines: It increases the secretions, but it is 
readily neutralized by the alkaline intestinal juices. 

Action after Absorption 

Acetic acid is rapidly absorbed from the stomach. It 
is oxidized in the blood to carbonic acid. It then forms 
carbonates by combining with the alkaline salts in the blood. 
The carbonates thus formed, are excreted by the urine; which 
is very much increased. 

Poisonous Effects 

The symptoms of poisoning by large doses of acetic acid, 
are similar to those caused by the mineral acids, but they 
are rarely fatal. The treatment is the same. 

Chronic Poisoning 

Continued use of acetic acid often causes emaciation, 
loss of weight, and anaemia. 

Preparations 

Vinegar (not official) 
Acetum 

Vinegar is obtained by prolonged fermentation of alcoholic 
liquors. The best vinegar is made from cider, and consists 
mostly of acetic acid. 

Dilute Acetic Acid 2.0-8.0 c.c. 5iH* 

(Acidum Aceticum Dilutum) 



524 MATERIA MEDICA 

This is a pure form of vinegar which contains 6% of 
acetic acid. 

These preparations are used principally to harden the 
skin, to check bleeding; and by inhalation, to relieve fainting 
(reflexly strengthening the heart action in this way). They 
are also used to neutralize poisoning from alkalies. 

For Local Use 

Glacial Acetic Acid 
(Acidum Aceticum Glaciale) 

This contains 99% of acetic acid. 

Trichloracetic Acid 
(Acidum Trichloraceticum) 

This is a crystalline substance. 

These two latter preparations are used to cauterize or 
destroy tissues. They are used principally to remove warts. 

CITRIC ACID 

Citric acid is an organic acid which is found in the juice 
of the lemon, or Citrus limonum, and the lime, Citrus bergamia. 

ACTION 

Citric acid acts like acetic acid. 

1. It increases the flow of saliva and relieves thirst. 

2. It increases the appetite and the flow of gastric juice, 
thereby aiding digestion. 

3. It slightly increases the movements of the bowels. 
Thus, the juice of half a lemon, if given before breakfast is 
a good laxative. 

4. It increases the sweat, especially if given hot, as in a 
hot lemonade. 

5. It slightly slows and weakens the heart action. 

6. It increases the flow of urine, in which it is secreted 
as a carbonate, and it makes the urine more acid in reaction. 

7. Citric acid is frequently given to sailors as an article 
of diet, to prevent scurvy, a severe disease of the joints due 
to the lack of vegetable food in the diet. 



ACIDS AND ALKALIES 525 

Citric acid is not a poisonous substance, but its continued 
use occasionally causes anaemia and loss of weight. 

Preparations 

The best way of administering citric acid is in the form of 
lemonade. To produce sweating it is best given hot. 

Citric Acid 
(Acidum Citricum) 

This is occasionally used in doses of 30.0 gms. (5i), to a 
pint of water; instead of lemonade. 

TARTARIC ACID 

Tartaric acid is the acid of grape juice. Its action is 
similar to that of acetic acid. 

It is principally used to increase the flow of urine, in which 
it is excreted as carbonates. 

It is also used as a laxative, and it is an ingredient of the 
seidlitz powder. 

Tartaric acid is usually given in the form of grape juice, 
as a cooling refreshing drink. As a diuretic or laxative, its 
various salts such as potassium tartarate, etc., are preferred. 

LACTIC ACID 

Lactic acid is a thick, syrupy liquid formed in milk when 
it turns sour as a result of bacterial fermentation. It is 
also formed by the fermentation of milk sugar or grape sugar. 

ACTION 

When taken internally, is acts like the other organic acids : 

1. It increases the appetite and aids digestion. 

2. It is said to increase nutrition. 

3. It enters the blood as lactates and is excreted by the 
urine as carbonates. 

It is principally used, however, as a local application to 
heal tuberculous ulcers of the pharynx or larynx, and to 
remove diphtheric membranes. The applications are very 
painful. 



526 MATERIA MED1CA 

Preparations 
Lactic Acid 0.3-2.0 c.c. m. v-xxx 

(Acidum Lacticum) 

This contains 75% of pure lactic acid. 

OXALIC ACID 

Oxalic acid is an organic acid, found in sorrel and other 
vegetable substances. It is never used as a medicine, but 
Potassium oxalate, or essential salt of lemon, and oxalic acid 
are frequently used to clean metal kitchen utensils. These 
salts resemble epsom salts in appearance, and are a frequent 
cause of severe poisoning, when taken by mistake, or with 
suicidal intent. 

Oxalic Acid Poisoning 

The symptoms usually appear in a few minutes: 

1. Severe burning pain in the mouth or throat. 

2. Intense cramp-like abdominal pain. 

3. Profuse vomiting, the vomited matter containing 
mucus, pieces of mucous membrane and blood. 

4. Muscular weakness and twitchings of the muscles. 

5. Occasionally convulsions. 

6. Collapse (rapid, irregular, weak, thready pulse, slow 
shallow breathing, cyanosis, cold moist skin, coma and 
death). 

The patient may die in a few minutes; or in a few weeks 
from starvation, as a result of the injury to the stomach and 
intestines. 30.0 gms. or Bi of oxalic acid usually proves fatal; 
though death has occurred from as little as 4.0 gms. (5i). 

Treatment 

1. Neutralize the oxalic acid at once with an alkali, such 
as calcium. Lime water, chalk or the plaster from the wall 
may be used for this purpose. 

Do not give any preparation of sodium or potassium, as 
these form poisonous substances with the oxalic acid. 

2. Give emetics. 



ACIDS AND ALKALIES 527 

3. Protect the mucous membranes with egg albumin, 
milk, etc. 

4. Treat the collapse with heart stimulants such as 
strychnine, caffeine, digitalis, etc. 

Other organic acids occasionally used are: 

Hydrocyanic Acid 
Tannic Acid 
Gallic Acid 

These are considered under their more important actions 
for which they are principally used. 



ALKALIES AND ALKALINE EARTHS 

The following drugs are used principally to neutralize 
acids. They are therefore often called antacids. 

An alkali is a substance which belongs to a group of 
chemical substances called bases. These neutralize acids to 
form salts. 

Alkalies combine with acids to form salts. They dissolve 
proteids, forming salt-like alkali proteids, and they combine 
with fats to form soaps. 

Mode of Action 

The alkalies and their salts are principally used to neu- 
tralize acids. When given internally, they combine with the 
acids in the stomach and form salts. They then relieve 
various symptoms which result from excessive acid in the 
stomach. 

Salt Action 

The salts which are formed in the stomach and intestine, 
or those which are given to a patient, if they are sufficiently 
concentrated, withdraw fluid from the blood and tissues, 
into the stomach and intestines, until these salts are diluted. 
This process is called osmosis. 

The diluted salts are absorbed into the blood through the 
mucous membranes, and they then circulate throughout the 
body, and enter the cells of the various organs and tissues. 
There they set up a process of diffusion; the cells absorbing 
fluid if the proportion of salt which it contains is more than 
that in the fluids around them; and the cells then become 
swollen. Some of the cells, such as those of the kidney, for 
example, then become more active. 

The rate of absorption of the various alkalies and their 
salts is variable; some being absorbed more slowly than 
others. Those that are very slowly absorbed, merely with- 
draw fluid into the intestines, which then become distended, 

528 



ACIDS AND ALKALIES 529 

peristalsis results and the salts act as a purgative. The most 
common alkalies that are used as medicines are the salts of 

Sodium 

Potassium 

Ammonium 

The alkaline earths are: 

Calcium 

Magnesium 

Lithium 



SODIUM COMPOUNDS 

Sodium is a metallic element. It is found in nature in 
various forms. 

1. As sodium chloride or salt, in salt mines, or obtained 
from sea water by evaporation. 

2. It is found in Chili as sodium nitrate. 

3. As borax or sodium borate in various parts of the 
world. 

ACTION 

Local action: Weak solutions of sodium compounds make 
the skin feel soft and soapy, by dissolving the superficial 
epidermis, or horny layer of the skin. Concentrated solu- 
tions destroy the skin and underlying tissues, forming a 
soft crust, which soon falls off, leaving an ulcer. Mucous 
membranes are affected in the same way as the skin. Sodium 
compounds as well as the compounds of the other alkalies, 
particularly dissolve mucous. 

Internal Action 

In the mouth: Sodium compounds, as well as the other 
alkalies, have a characteristic alkaline taste. 

They dissolve the mucous secretions, redden and soften the 
lining membrane of the mouth and tongue and make the 
mouth feel soapy. 

In the stomach: They neutralize the acid in the stomach, 
thereby lessening digestion. They combine with the acids 
to form salts. 



530 MATERIA MEDICA 

In the intestines: The alkalies enter the intestines as salts 
which have been formed in the stomach. They withdraw 
fluid from the blood and tissues which then distends the 
intestines and causes frequent movements of the bowels. 
It also dissolves the mucus in the intestine. 

Action after Absorption 

The salts of sodium are readily absorbed into the blood, 
which they then make more alkaline in reaction. They do 
not particularly affect the activity of any of the organs of the 
body. They are excreted mainly by the kidneys; increasing 
the flow of urine at the same time, and they make the urine 
more alkaline in reaction. They are also slightly excreted 
by the mucous membranes. 

Preparations 
Sodium Hydroxide 
(Sodii Hydroxidum) 

(Caustic Soda) 

This comes in white sticks, which readily take up moisture 
from the air. It is occasionally applied as a caustic, to 
destroy tissue. It often causes severe injury to the tissues. 

Solution of Sodium Hydroxide 1.0-4.0 c.c. m. xv-5i 

(Liquor Sodii Hydroxidi) 

This is a 5% solution of sodium hydroxide in water. 

Monohydrated Sodium Carbonate 0.3-2.0 gms. grs. v-xxx 
(Sodii Carbonas Monohydratus) 

Sodium Carbonate 0.3-2.0 gms. grs. v-xxx 

(Sodii Carbonas) 

(Washing Soda) 

These two preparations are rarely used internally. Ex- 
ternally they are used to dissolve mucus and other secretions. 
They are frequently used to clean glass, china, woodwork, 
etc. They frequently cause poisonous symptoms when taken 
by mistake. 

Sodium Bicarbonate 0.3-2.0 gms. grs. v-xv 

(Sodii Bicarbonas) 



ACIDS AND ALKALIES 531 

This is the most commonly used preparation. It is 
applied locally to soothe the skin; in burns. Internally it is; 
said to neutralize the acid in the stomach, and to relieve the 
pains resulting from excessive acid. It is given in seltzer or 
vichy. It is frequently used to soothe the stomach and to 
lessen vomiting. 

Troches of Sodium Bicarbonate 
(Troschisci Sodii Bicarbonatis) 

There are numerous other preparations such as seidlitz 
powder, which contains sodium bicarbonate, but these are 
used principally as cathartics. 



POTASSIUM COMPOUNDS 

The salts of potassium act like the sodium compounds 
with the following variations in their effects : 

1. Concentrated solutions such as potassium hydroxide, 
have a greater destructive action on the skin. They destroy 
the skin and underlying tissues, causing an ulcer when the 
resulting crust falls off. 

2. The salts of potassium when absorbed into the blood, 
slightly weaken and slow the contractions of the heart. 

3. They increase the flow of urine more than the sodium 
compounds. 

The potassium salts are very rarely used as alkalies. 

Preparations 
Potassium Hydroxide 
(Potassii Hydroxidum) 

(Caustic Potash) 

This comes in white sticks which take up moisture from 
the air. It is used principally as a caustic, to destroy tissues. 
When this is applied locally, the surrounding tissues about 
the spot to be cauterized, should be well protected owing to 
its violent action. 

Solution of Potassium Hydroxide 0.6-2.0 c.c. m. x-xxx 
(Liquor Potassii Hydroxidi) 



532 MATERIA MEDICA 

This contains 5% of potassium hydroxide. 

Potassium Carbonate 0.3-2.0 gms. grs. v-xxx 

(Potassii Carbonas) 

Potassium Bicarbonate 0.3-2.0 gms. grs. v-xxx 

(Potassii Bicarbonas) (saleratus) 

Potash and Lime 
(Potassa cum Cake) 

This is known as Vienna paste, and consists of equal parts 
of potash and quicklime and is used locally as a caustic. 

Various salts of ammonium are used as alkalies or ant- 
acids. Their action has been described under their other 
more important effects. 

Poisonous Effects of Alkalies 

Acute poisoning frequently results from some of the 
alkalies when they are taken by mistake. Washing soda, 
lye, or sodium carbonate is commonly used for cleaning 
purposes. It is found in every household, and if carelessly 
left around the house, it is occasionally taken by children, 
producing very serious symptoms. 

Symptoms of Alkali Poisoning 

The symptoms usually appear in a few minutes after the 
alkali has been taken : 

1. The tissues about the lips and mouth are destroyed and 
covered with a swollen white crust, and there are pieces of 
bloody moist shreds of tissue around the lips and mouth. 

2. Severe abdominal pains. 

3. Profuse vomiting. The vomited matter contains pieces 
of mucous membrane and blood. 

4. Occasionally there is diarrhoea, the stools containing 
blood and pieces of mucous membrane. 

5. Collapse (rapid thready pulse, slow shallow breathing, 
cold moist skin, and dilated pupils). 

The patient may die of collapse, or occasionally from a 
perforation of the stomach wall, resulting from the destruc- 
tive action of the alkali. 

If the patient recovers, the scars which form at the areas 



ACIDS AND ALKALIES 533 

in the oesophagus and stomach where the tissue was de- 
stroyed, makes these organs narrower (stenosis). This con- 
dition may necessitate radical surgical treatment. 

Treatment 

1. Give as an antidote, a dilute vegetable acid such as 
lemon juice, vinegar or dilute acetic acid. 

2. Protect the mucous membrane by egg albumin, oils 
or milk. 

3. Treat the collapse with heart stimulants; such as 
caffeine, strychnine, atropine, digitalis, etc., and keep the 
patient warm. 

Do not wash out the stomach, as passing a stomach tube may 
cause a perforation of the stomach. 

Uses of the Alkalies 

The alkalies are principally used : 

1. To neutralize the acid in the stomach, in hyperacidity, 
a condition where there is too much acid secreted in the 
stomach. It is also given in ulcers of the stomach where the 
pain is due to the excessive amount of acid formed in the 
stomach, which is then neutralized by the alkalies. In 
these cases the alkalies are best given about a half to one 
hour after meals, when the stomach contains the largest 
amount of acid. 

2. They are also used to dissolve mucus and other secre- 
tions. 

ALKALINE EARTHS 

The most common alkaline earths that are used in medi- 
cine are the salts of calcium and magnesium. These salts 
differ from the alkalies in being very insoluble. They are 
therefore not readily absorbed, and produce only a local 
effect in the stomach and intestines. 

CALX OR CALCIUM (LIME) 

Calcium salts are found very abundantly in nature. They 
are found in large quantities in all the tissues of animals. 



534 MATERIA MEDICA 

As calcium phosphate, it is found in the bones and teeth of 
all animals. It is also found in many of the soft tissues. 
Calcium salts are necessary for the activity of many forms of 
living matter. 

Many mineral substances, also contain large quantities 
of calcium salts. Thus, calcium carbonate is found in 
chalk, marble and limestone. Calcium sulphate is found in 
plaster of paris, gypsum and alabaster. 

ACTION 

Local action: The calcium salts have no effect on the 
skin, but they contract the mucous membranes, and are 
very soothing to them (astringent action). 

Calx or unslaked lime however, burns and destroys 
tissues if applied to mucous membranes. 

Internal Action 

In the mouth: The calcium salts contract the mucous 
membranes. 

In the stomach: They neutralize the acid, lessen digestion 
and contract and soothe the mucous membranes. 

In the intestines: They contract and soothe the mucous 
membrane (astringent action). 

Action after Absorption 

The calcium salts are very slowly absorbed from the 
stomach and intestines. Part of these salts are absorbed 
into the blood, however, and help to form fibrin ferment, so 
that the blood clots better. 

In diseases where there is an insufficient amount of 
calcium or lime in the body, such as rickets, the bones be- 
come softened and are often deformed. The calcium ab- 
sorbed from the blood is then deposited in the bones and 
hardens them. 

Excretion 

The calcium salts are excreted mostly by the large intes- 
tine and kidneys. 



ACIDS AND ALKALIES 535 

Poisonous Effects 

Poisoning from lime occasionally occurs when unslaked 
lime is swallowed. The symptoms are the same as those of 
poisoning by other alkalies. 

Slaked lime occasionally causes severe destruction of the 
tissues. It gets into the eye accidentally every now and 
then, in those whose work necessitates its constant handling. 
Severe destruction of the eye, even loss of sight, may then 
result. In such cases, the eyes should immediately be washed 
out very thoroughly with a solution of boric acid. 



Uses 

Solutions of calcium are used locally to soothe the skin in 
burns. Internally, it is used to neutralize the acids of the 
stomach in hyperacidity, or ulcer of the stomach. It is also 
used to soothe the stomach and lessen nausea and vomiting. 

When given to neutralize the acid, it is best given about a 
half to one hour after meals, when the stomach contains the 
largest amount of acid. 

They are also used as antidotes for poisoning by acids. 

Preparations 

For Internal Use 

Lime Water 30.0-120.0 c.c. 5hv 

Solution of Calcium Hydrate 
(Liquor Calcis) 

This is a saturated solution of calcium hydrate or slaked 
lime containing 0.17 gm. of calcium hydrate to 100.0 c.c. of 
water, or grs. £-} to §i of water. 

It is made by washing slaked lime with distilled water, 
and then filtering the resulting solution. 

It is used to neutralize the acid in the stomach, to soothe 
the stomach and to lessen nausea and vomiting. It is very 
constipating. 

When added to milk, it lessens curdling in the stomach 
and makes the milk more digestible. 



536 MATERIA MEDICA 

Syrup of Lime l.O^r.O c.c. m. xv-5i 

Syrup of Calcium Hydroxide 
(Syrupus Calcis) 

This contains 5% of lime. 

Calcium Chloride 0.3-1.0 gm. grs. v-xv 

(Calcii Chloridum) (well diluted) 

This is used to increase the clotting of the blood. It is 
somewhat injurious to the tissues however. When fresh it is 
a good antiseptic, gvi of the calcium chloride being used to 
a gallon of water. 

Calcium Lactate (not official) 0.2-0.6 gm. grs. iii-x 
(Calcii Lactas) 

This is used principally to increase the clotting of the 
blood in haemorrhage. It is frequently given for several 
days before tonsil and adenoid operations to prevent profuse 
bleeding. It is occasionally given hypodermically. 

For Local Use 
Lime Liniment 
(Linimentum Calcis) 
Carron Oil 

This is a mixture of lime water and olive or linseed oil in 
equal parts. 

Unslaked Lime 
Calx 

This is made from limestone. It forms a white mass 
which cracks, and changes to a powder, when placed in water, 
forming heat. It is then called slaked lime or quick lime. 

It is used as a disinfectant and to destroy tissue (caustic) . 

For this purpose it is used together with potassium in 
the form of vienna paste or potassa cum calce. 

Milk and Lime (non-official) 
Whitewash 

This is made by adding 1 part of slaked lime to 4 parts of 
water. It is used as a disinfectant, especially for typhoid 
and cholera stools. It is also a soothing application for 
burns. 



ACIDS AND ALKALIES 537 

Chalk Mixture 15.0-30.0 c.c. 5}-i 

(Mistura Cretae) 

This contains 2.0 gms. chalk suspended in 30.0 gms. water 
by means of gums. 

MAGNESIA 

The preparations of magnesia act similarly to those of cal- 
cium. 

1. They neutralize the acid in the stomach. 

2. They are not readily absorbed, passing into the intes- 
tines, where they act as cathartics, causing frequent fluid 
stools. 

3. The small amount of magnesia that is absorbed, in- 
creases the alkaline reaction in the blood, and is excreted 
by the urine, which it increases and makes more alkaline in 
reaction. 

Preparations 

The preparations of magnesia, which are principally used 
to neutralize the acid in the stomach, are : 

Magnesium Oxide 0.3-4.0 gms. grs. v-5i 

(Magnesii Oxidum) 

(Calcined or light magnesia) 

(The Magnesia Usta of the German Pharmacopoeia) 

Milk of Magnesia 4.0-16.0 c. c. 3i~5i 

This is a proprietary preparation containing magnesium 
hydrate. It is used as an antacid and cathartic. 

The other preparations of magnesia are principally used 
as cathartics, under which group they are described. 

LITHIUM 

The salts of lithium are also alkaline in reaction and 
neutralize the acid in the stomach. They are principally 
used as diuretics and are described in that group. 






CHAPTER XXI 

ASTRINGENTS 

Astringents are drugs which are used to contract the 
tissues with which they come in contact. If they are applied 
to mucous membranes, by contracting their cells, they 
lessen the secretions. 

Astringents affect the tissues only locally; by the drugs 
combining with the proteids or albumins of the cells and 
thereby coagulating and hardening them. 

To produce its effect, an astringent must therefore come 
directly in contact with the tissues upon which it acts. In 
large doses, the excessive coagulation of the proteids of the 
cells destroys the tissues, and they then act as caustics. 

Astringents are divided into two groups; depending upon 
the nature of the substance used for this purpose. Vegetable 
astringents and mineral astringents. 

VEGETABLE ASTRINGENTS 

Vegetable astringents are vegetable substances whose 
principal action is to contract the tissues and lessen the 
secretion of the mucous membranes. These effects which 
they produce are due to an organic acid, tannic acid which 
all of them contain. 

TANNIC ACID 

Tannic acid is an organic acid which is found in a great 
many vegetable substances. It is obtained from powdered 
nutgall or oak gall. This is a vegetable growth produced in 
the bark of the Quercus lusitannica, dyers' oak, or the 
gall oak tree, by the puncture of a fly (the Cynips gallae 
tinctoriae) and the deposit of its eggs on this bark. 

538 



ASTRINGENTS 539 

There are various forms of tannic acid, depending on the 
plant from which it is derived; for example, gallotannic acid, 
from nutgall, kinotannic acid from kino, catechutannic acid 
from catechu, etc. 

Tannic acid is very closely related to gallic acid; which is 
tannic acid combined with water. 

ACTION 

The action of tannic acid is due to the coagulation of the 
proteids of the cells with which it comes in contact. 

Local action: Applied to the skin, to a wounded surface or 
ulcer, it contracts the tissues by coagulating or hardening 
their cells. If applied to a bleeding point, it stops the bleed- 
ing by coagulating the proteids of the blood. 

On mucous membranes : It checks the secretion, and makes 
them dry and contracted by hardening their cells. 

Internal Action 

In the mouth: It has a harsh bitter taste, and makes the 
mouth feel dry and contracted. 

In the stomach and intestines: It contracts the mucous 
membrane, thereby checking its secretions and making it 
less susceptible to impulses that start peristalsis, which is 
then lessened, and the bowels are constipated. 

Action after Absorption 

Part of the tannic acid is changed in the intestine to gallic 
acid and to a salt, a tannate, which is then absorbed into 
the blood, but which produces no effects on the tissues or 
organs of the body. 

Excretion 

Most of the tannic acid is destroyed in the body, while 
a very small amount is eliminated in the stools and urine as 
tannic acid, gallic acid or pyrogallic acid. 

Poisonous Effects 
Tannic acid is not a strong poison. Large doses, by the 



540 MATERIA MEDICA 

destruction of many of the cells of the mucous membranes 
of the alimentary tract, often cause nausea, vomiting and 
diarrhoea. 

Uses 

Tannic acid preparations are used principally: 

1. To check excessive secretion of the alimentary tract, 
as in diarrhoea. 

2. To check excessive secretion and swelling of mucous 
membranes, as in the diseased condition of the mouth in 
mercury poisoning. 

3. To prevent bed sores by hardening the skin. 

4. As an antidote to various metallic and alkaloid poisons. 

5. It is often given as an astringent irrigation in the colon 
and vagina. 

Administration 

For local effect it should be given in the form of an oint- 
ment or a lotion. 

For its effect in the stomach, it is best given in powder 
form. 

For its effect in the intestines, it is best given in pill form. 

Preparations 

Tannic Acid 0.12-0.6 gm. grs. ii-x 

(Acidum Tannicum) 

Troches of Tannic Acid 0.06-gm. gr. i 

(Trochisci Acidi Tannici) 

For Local Use : 
Glycerite of Tannic Acid 
(Glyceritum Acidi Tannici) 
This contains 20% of tannic acid. 

Tannic Acid Ointment 
(Unguentum Acidi Tannici) 
This contains 20% of tannic acid. 

Styptic Collodion 
(Collodium Stypticum) 
This contains 20% of tannic acid. 



ASTRINGENTS 541 

New and Non-official Preparations 

These preparations are not so apt to cause nausea and 
vomiting and are milder in their action. 

Tannalbin 1.0-4.0 gms. grs. xv-5i 

Tannin Albuminate 
(Albuminas Tannas) 

This is a compound of tannic acid in albumin and is used 
to check diarrhoea. It is not dissolved in the stomach and 
acts only in the intestines. 

Tannigen 0.2-0.6 gm. grs. iii-x 

Tannyl Acetate 

(Acidum Tannicum Diacetylicum) 

It is used to check diarrhoea and acts in the intestine 
when it comes in contact with the intestinal juice. 

Tannoform 0.25-0.5 gm. grs. iv-viii 

(Tanninformaldehydum) 

This is a compound of gallotannic acid with formaldehyde. 
It is an astringent and antiseptic and is used to check di- 
arrhoea. 

It is also used locally as a powder in 25% to 50% solutions 
or as a 10% ointment for eczema, profuse sweating, etc. 

Tannopin or Tannon 0.3-0.5 gm. grs. v-viii 

Hexamethylene Tetramine Tannin 

This is used as an astringent and as an antiseptic in the 
intestines in chronic colitis, tuberculous enteritis, etc. 

Protan 1.0-2.0 gms. grs. xv-xxx q. 2 h. 

Tannin Nucleo Proteid 

For children, 0.3-0.6 gm. grs. v-x q. h. 
This is a compound of casein and tannic acid, containing 
50% of tannic acid. It is used to check diarrhoea. 

Tannacol 1.0-2.0 gms. grs. xv-xxx 

Gelatine Tannate 

This is used to check diarrhoea. 



542 MATERIA MEDICA 



GALLIC ACID 

Gallic acid is an organic acid which is usually made from 
tannic acid by its combination with water. 

ACTION 

Gallic acid does not coagulate albumins, and it has a 
milder action than tannic acid. It is more readily absorbed 
into the blood, and is only used to check excessive secretion 
of sweat, of bronchial mucus and to check bleeding from the 
lungs or kidney, but it is not very effective. 

Preparations 

Gallic Acid 0.3-2.0 gms. grs. v-xxx 

(Acidum Gallicum) 

GALLOGEN (not official) 

Gallogen, ellagic or benzoaric acid is an acid obtained 
from the pods of the divi divi plant or Coesalpina coraria. 
It checks diarrhoea and contracts mucous membrane. 
It is given in doses of 0.6-1.0 gm. (grs. v-xv) 



VEGETABLE SUBSTANCES CONTAINING TANNIC OR 
GALLIC ACIDS 

GALLA (NUTGALL) 

Galla or nutgall is a growth which forms on the bark of 
the Quercus infectoria, or gall oak tree, by the punctures 
and the deposited eggs of a species of fly (Cynips tinctoria). 
Before the larvae are formed from the ova, the galls contain 
about 50% of tannic acid and smaller quantities of gallic 
acid. 

ACTION 

Nutgall contracts the tissues and checks the secretion of 
mucous membranes because of the tannic acid which it con- 
tains. It is little used except in the form of an ointment, as 
a local application for haemorrhoids. 



ASTRINGENTS 543 

Preparations 

Tincture of Nutgall 2.0- 12.0 gms. grs. xxx-5iii 

(Tinctura Gallae) 

Nutgall Ointment 
(Unguentum Gallae) 

Gall and Opium Ointment (not official) 
(Unguentum Gallae cum Opii) 

This contains 7|% of opium. 

GAMBIR 

Gambir or pale catechu is an extract made from the leaves 
and twigs of Ouraparia gambir, an East Indian shrub. It is 
used as a powerful astringent; contracting the tissues and 
checking the secretions of mucous membranes, because of 
the tannic acids which it contains. 

Preparations 

Gambir 1.0 gm. grs. xv 

Compound Tincture of Gambir 4.0 c.c. 5i 

(Tinctura Gambir Composita) 

Troches of Gambir, each containing 0.06 gm. gr. i 
(Trochisci Gambir) 

CATECHU 

Catechu is an extract prepared from the wood of Acacia 
catechu, an East Indian plant. 

It is a powerful astringent because of the tannic acid which 
it contains. It is not often used. 

Preparations 

Tincture of Catechu 2.0-4.0 c.c. 3j— i 

(Tinctura Catechu) 

Troches of Catechu, each contains 0.06 gm. gr. i 

(Trochisci Catechu) 

Compound Catechu Powder 0.6-2.0 gms. grs. x-xxx 
(Pulvis Catechu Compositus) 



544 MATERIA MEDICA 

This contains catechu, kino, krameria, cinnamon and nut- 
meg. 

KRAMERIA (RHATANY) 

Krameria is obtained from the roots of Krameria triandra, 
and of Krameriai Ixima, para rhatany, and peruvian rhatany, 
two South American shrubs. 

They are powerful astringents, contracting the tissues and 
checking the secretions, because of the tannic acid which they 
contain. 

Preparations 

Extract of Krameria 0.3-1.0 gm. grs. v-xv 

(Extractum Krameriae) 

Fluidextract of Krameria 0.6^.0 c.c. m. x-5i 

(Fluidextractum Krameriae) 

Tincture of Krameria 2.0-8.0 c.c. 5j-ii 

(Tinctura Krameriae) 

Syrup of Krameria 2.0-10.0 c.c. 3i~ii| 

(Syrupus Krameriae) 

KINO 

Kino is the dried juice of the Pterocarpus marsupium, an 
East Indian tree. 

It is a strong astringent, contracting tissues and checking 
the secretions of the mucous membranes, because of the 
tannic acid which it contains. 

Preparations 

Tincture of Kino 2.0-8.0 c.c. 5i~ ii 

(Tinctura Kino) 

HAMAMELIS (WITCH HAZEL) 

Hamamelis or witch hazel, is obtained from the leaves, 
bark and twigs of Hamamelis virginiana, an American plant. 
It contains tannic acid and a volatile oil. 

It contracts the tissues and checks the secretions of mu- 
cous membranes. It is used to check bleeding and to lessen 
inflammations. 



ASTRINGENTS 545 

Preparations 

Fluidextract of Witch Hazel Leaves 2.0 c.c. m. xxx 
(Fluidextractum Hamamelis Foliorum) 

Extract of Witch Hazel 8.0 c.c. 5ii 

(Aqua Hamamelis) 

This is a colorless alcoholic fluid made by distilling the 
leaves and twigs of witch hazel. It contains very little 
tannic acid and a volatile oil. 

HAEMATOXYLON 

Haematoxylon is obtained from the wood of the logwood 
tree or the Haematoxylon campechianum, a Central Ameri- 
can tree. 

It is an excellent astringent, contracting the tissues, and 
checking the secretions of mucous membranes, because of 
tannic acid which it contains. It is used to check diarrhoea, 
but it is apt to stain sheets and linens a bright red color. 
It is also used in the laboratory, to stain tissues for micro- 
scopic examination. 

Preparations 

Extract of Haematoxylon 0.6-2.0 gms. grs. x-xxx 

(Extractum Haematoxylii) 

GERANIUM 

Geranium is the underground root of the Geranium macu- 
latum, crow's foot or crane's bill, an American plant. 

It is used as an astringent to contract the tissues and to 
check the secretions of mucous membranes. 

Fluidextract of Geranium 2.0-4.0 c.c. 3 J— i 

(Fluidextractum Geranii) 

RUBUS (BLACKBERRY) 

Rubus or blackberry is the bark of the roots of various 
species of the blackberry plant, such as Rubus villosus, 
Rubus canadensis and Rubus trivialis. 



546 MATERIA MEDICA 

It is used as an astringent to contract the tissues and check 
the secretions of mucous membranes, because of the tannic 
acid which it contains. 

Preparations 

Fluidextract of Blackberry 2.0-8.0 c.c. 5Hi 

(Fluidextractum Rubi) 

Blackberry brandy is a common household remedy used to 
check diarrhoea. 

QUERCUS 

Quercus is the bark of the white oak tree. It contracts 
the tissues and checks the secretions of the mucous mem- 
branes, because of quercitannic acid which it contains. It 
is used as an enema in prolapsus recti or haemorrhoids, 
and as a vaginal douche. 

Preparations 

Fluidextract of Quercus 1.0 c.c. m. xv 

(Fluidextractum Quercus) 

RHUS GLABRA (SUMACH) 

Rhus glabra is obtained from the fruit of Sumach berries, 
It contains tannic and mallic acids. 

It is used as an astringent gargle, diluted in two parts 
of water, for sore throat and pharyngitis. 

Preparations 

Fluidextract of Rhus Glabra 
(Fluidextractum Rhois Glabrae) 

ROSA GALLICA (RED ROSE PETALS) 

Rosa gallica consists of the red rose petals, gathered be- 
fore the flowers open up. 

It is used as a mild astringent and as a flavoring ingred- 
ient. 



ASTRINGENTS 547 

It usually comes in the form of a fluidextract, a honey, 
a syrup, and as a confection, for flavoring purposes. 
For local use, the following preparations are used: 

Stronger Rose Water 
(Aqua Rosae Fortior) 

Rose Water 
(Aqua Rosae) 

Cold Cream or Rose Ointment 
(Unguentum Aqua Rosae) 

CAMELLIA THEA (TEA PLANT) 

Tea leaves contain large amounts of tannic acid. If they 
are boiled for a long time, and the leaves then squeezed out, 
the resulting fluid contains large amounts of tannic acid. 

Chamomile, jambul, and many of the vegetable substances 
used as bitters, contain large amounts of tannic acid, and 
have, therefore, an astringent action. 

MINERAL ASTRINGENTS 

Mineral astringents are mineral substances which are 
used to contract tissues and to check the secretions of mu- 
cous membranes. Most of these substances are metals and 
their salts. The principal salts used for this purpose are the 
salts of lead, silver, aluminium, zinc, copper and bismuth. 
They usually act by coagulating the albumins of the cells, 
forming an albuminate of one of these metals. Many of 
their preparations are already combined with albumins. 
These are not as injurious to the tissues and are milder in 
their action than the others. 

Of the various salts of the metals, the chlorides and the 
nitrates have the greatest coagulating power on the cells 
and the tissues, while the sulphates have less action. 

LEAD (PLUMBUM) 

Lead is a heavy metal; which forms salts by combining 
with acids, many of which are used in medicine. 



548 MATERIA MEDICA 

ACTION 

Local action: Applied to the skin, solutions of lead salts 
produce no effect, but on ulcers or wounded surfaces they 
coagulate the albumins of the superficial layer of cells, and 
harden them. In this way, they form a thin covering of 
coagulated albumin, which protects the cells from injury 
and promotes their healing. If applied to a bleeding spot, 
it stops bleeding by coagulating the albumins of the blood. 
Mucous membranes are contracted, by coagulation of the 
albumins of their cells, and their secretions are checked. 

Internal Action 

In the mouth: It has a sweet metallic taste, and it makes 
the mouth feel dry and contracted. 

In the stomach and intestines: It checks the secretions, 
and lessens peristalsis, thereby causing constipation. 

Absorption 

Lead salts combine with the albumins in the stomach 
and intestines, and are then absorbed into the blood as lead 
albuminates, which are deposited in the various tissues of 
the body. They produce no effects after absorption, except 
perhaps if given in large doses continually, when they may 
make the pulse somewhat slower and stronger. 

Excretion 

Lead salts are very slowly eliminated from the body in 
the urine, the bile, the intestinal secretions, the saliva and 
the milk. The stools usually turn black from the lead sul- 
phides which form in the intestine. 

Poisonous Effects 

When large doses of several of the lead salts, such as the 
lead acetate, are taken, acute poisoning occasionally results. 

Symptoms 
1. Severe abdominal pain. 



ASTRINGENTS 549 

2. Nausea and vomiting, with blood in the vomited 
matter. 

3. Diarrhoea with bloody stools, though often there is 
constipation. 

4. Collapse. 

5. Coma, paralysis and death. 

Treatment 

1. Wash out the stomach. 

2. Give dilute sulphuric acid. 

3. Give milk or albumin water to protect the mucous 
membrane of the stomach and intestines. 

4. Treat the collapse with heart stimulants. 

Chronic Lead Poisoning 

Chronic lead poisoning is the most common form of 
poisoning by metals. It occurs particularly in workers 
who are forced to handle lead or its salts, such as white 
lead, or type, continuously. Painters, type setters, plumbers 
and glaziers are frequently affected, the lead being absorbed 
from the skin, or getting on the food from the hands. 

Occasionally, lead poisoning results from drinking water 
coming through lead pipes, or eating canned food from cans 
soldered with lead, or from food adulterated with lead; such 
as cakes colored with chromate of lead, etc. It often occurs 
from inhaling lead fumes in a room painted with lead paint, 
and occasionally in children, from putting lead pencils in 
the mouth. It also often occurs from absorption of oint- 
ments or solutions applied to wounds or ulcers. 

The symptoms appear very slowly and vary in different 
individuals. They result from the lead affecting the ali- 
mentary tract, the blood and the nerves. 

Symptoms 
Symptoms of the Alimentary Tract 

1. Loss of appetite, nausea, metallic taste in the mouth 
and bad breath. 

2. " Lead line " on the gums. This is a dark blue line of 



550 MATERIA MEDICA 

lead sulphide which is deposited at the junction of the gums 
and teeth. It may be absent if the teeth are kept very 
clean. 

3. " Lead Colic " or painter's colic. 

This is a very characteristic symptom, and usually ap- 
pears suddenly. The patient complains of severe cramp- 
like abdominal pains, usually beginning around the navel, and 
lasting for several days, after which they disappear but soon 
return. 

4. Obstinate constipation. 

5. Occasionally vomiting. 

6. Slow strong pulse. 

Symptoms of the Blood 

1. Anaemia: The blood cells often contain very small 
granules of lead. 

2. Occasionally, abortion in pregnant women. 

Symptoms of the Nerves 

These symptoms appear later. 

1. Lead paralysis, lead palsy or painter's palsy. The 
extensor muscles of both forearms usually become paralyzed, 
and the hands drop as a result of the contractions of the 
flexor muscles ("drop wrists"). Other muscles may be 
similarly affected. 

2. Loss of sensation in areas of the skin. 

3. Sharp, shooting or boring pains around the joints 
(arthralgia). 

4. Rarely, blindness, from affection of the optic nerve. 

5. " Encephalopathia Saturnina." These are various symp- 
toms which occur very rarely, and are the result of the 
effect of lead on the brain. 

Headache, dizziness, sleeplessness, deafness, stupor, weak- 
ness. Occasionally nausea, delirium, convulsions, hallucina- 
tions, etc. 

In individuals who have had repeated attacks of lead 
poisoning, or who are exposed to lead continuously, the 
destruction of the cells in various organs of the body, and 



ASTRINGENTS 551 

their replacement by connective or scar tissue, results in 
various chronic diseases. Thus, chronic nephritis often 
results from the destruction of many of the kidney cells. 
Arteriosclerosis or hardening of the arteries, often results 
from the destruction of the cells of the blood vessel walls, 
and their replacement by connective tissue. Gout frequently 
results in patients who are continually exposed to lead. 

Treatment 

1. Individuals who are continually exposed to lead or its 
salts, can often avoid poisonous symptoms by keeping their 
hands and nails scrupulously clean, especially before eating; 
to avoid getting the lead particles in the mouth. They should 
move the bowels regularly, best by epsom salts, and they 
should take dilute sulphuric acid in lemonade regularly. 
Their diet should contain plenty of milk. 

The patients suffering from an attack of chronic lead 
poisoning should be treated in the following way. 

1. Move the bowels regularly by magnesium or sodium 
sulphate, which also helps to neutralize the lead, forming a 
lead sulphide, which is then excreted in the intestines. 

2. Give potassium iodide, which helps to eliminate the 
lead. 

3. Potassium sulphide baths also often help to eliminate 
the lead. 

4. The lead colic is best controlled by atropine. 

5. For the anaemia, iron should be given. 

6. The paralyses usually get well if carefully treated 
with electricity and massage. 

Uses 

Lead salts are used principally on ulcers and wounds, to 
contract the tissues, and to check bleeding. 

The lead acetate is occasionally given to check diarrhoea. 

Preparations 

Lead Acetate 0.06-0.3 gm. grs. i-v 

(Plumbi Acetas) 
(Sugar of Lead) 



552 MATERIA MEDICA 

For Local Use : 
Solution of Lead Subacetate 
(Liquor Plumbi Subacetatis) 
(Goulard's Extract) 

This contains about 25% of lead subacetate. It should 
be diluted, about 5 i being used to a pint of water. 

Dilute Solution of Lead Subacetate 
(Liquor Plumbi Subacetas Dilutum) 

This contains § part of lead subacetate to 1000 c.c. of 
water. 

Cerate of Lead Subacetate 
(Ceratum Plumbi Subacetas) 
(Goulard's Cerate) 

This consists of lead subacetate solution, wool fat, white 
vaseline and camphor. 

Lead Iodide 
(Plumbi Iodidum) 

Lead Plaster 
(Emplastrum Plumbi) 

(Diachylon Plaster) 

This consists of lead oxide, soap and water. 

Adhesive Plaster 
(Emplastrum Adhaesivum) 

This consists of rubber, lead plaster, and vaseline. 

Soap Plaster 
(Emplastrum Saponis) 

This consists of soap, lead plaster and water. 

Diachylon Ointment 
(Unguentum Diachylon) 

This consists of lead plaster, olive oil and oil of lavender. 

SILVER (ARGENTUM) 

Silver is a white hard glistening metal. The only salt of 
silver which is used to any extent in medicine is the silver 
nitrate. 



ASTRINGENTS 553 

Silver has been used in medicine for centuries, particularly 
by the Arabians, who used it extensively in the treatment of 
nervous diseases. In their system of medicine, which was 
based upon astrology, silver was associated with the phases 
of the same planet, the moon, as nervous diseases were; 
hence the name lunar caustic for silver nitrate. 

ACTION 

Silver salts coagulate or harden the albumins of the 
cells, thus forming an albuminate of silver, which is a thick, 
firm precipitate. If the preparation of silver is already com- 
bined with an albumin, its action is milder and it is not 
injurious to the tissues. 

Local action: Applied to the skin, ulcers or wounded sur- 
faces, dilute solutions of silver nitrate cause slight redness 
and itching, and contract the tissues. It also acts as an 
antiseptic, checking the growth of bacteria. Concentrated 
solutions destroy the skin by coagulating or hardening the 
albumins of the cells. The destroyed tissue or slough, is 
white in color, but soon turns brown or black on exposure to 
light. Mucous membranes are contracted by dilute solu- 
tions, and their secretions are lessened. Concentrated 
solutions, however, cause redness, swelling and destruction of 
the tissues. 

Internal Action 

When taken internally, silver salts have a metallic taste. 
They contract and lessen the secretions of the mucous mem- 
brane of the mouth, stomach and intestines. 

Very small quantities of the silver salts are absorbed as 
albuminates, if given continually for some time. They are 
then deposited between the cells of the tissues of the body, 
but they produce no effects after absorption. 

Excretion 
Silver salts are excreted mostly by the intestines. 

Poisonous Effects 

Acute poisoning occasionally results from silver nitrate, 
taken by mistake, either in solution or in solid form. 



554 MATERIA MEDICA 

Symptoms 

1. Burning pain in the mouth, throat and stomach. 

2. Nausea and vomiting; the vomited matter contains 
pieces of mucous membrane and often blood. 

3. Diarrhoea, with blood and flakes of mucous membrane 
in the stools. 

4. If a solution has been taken, the mouth is covered with 
a grayish white membrane which soons turns black. 

5. Collapse (rapid, thready weak pulse, slow shallow 
breathing, cold moist skin and dilated pupils). 

6. Coma, convulsions and death. 

Treatment 

1. Give plenty of common salt immediately, as an anti- 
dote. This neutralizes the silver, forming silver chloride. 

2. Protect the mucous membranes with milk, albumin 
water, and other protecting drinks. 

3. Treat the collapse with heart stimulants. 

Chronic Silver Poisoning (" Argyria ") 

Argyria is a condition which results from prolonged use of 
silver salts, but this condition is not now very common. 

The silver salts are absorbed into the blood, and deposited 
in the various tissues of the body which then turn a dark 
color on exposure to light. This turns the skin a dark gray 
or slate color. The skin of the entire body may be thus 
affected, or only various regions, such as the face, the gums, 
etc. 

Potassium iodide may be given for this condition, which 
does not usually respond to treatment. 

Uses 

Silver salts are used to check the growth of granulation 
tissue (newly formed connective tissue) and to contract the 
mucous membranes of the eye, the nose, or the mouth when 
these are inflamed. 

The salts of silver are particularly valuable in the treat- 
ment of gonorrhoeal infections; destroying the gonococci, 
which cause the disease. 



ASTRINGENTS 555 

Preparations 

The preparations of silver are divided into inorganic and 
organic preparations. The inorganic preparations are the 
ordinary salts formed by the combination of silver with a 
mineral acid. The organic preparations are formed by the 
combination of silver with albumin. 

Inorganic Preparations 

Silver Nitrate 0.01-0.03 gm. grs. i~i 

(Argenti Nitras) 

This is used in 1 to 2% solutions dropped in the conjunc- 
tiva of the eye, in newly born infants, to prevent gonorrhoeal 
opthalmia. In other gonorrhoeal infections and for other 
conditions, it is used in much weaker solutions such as 
1-10000 to 1-1000. 

Silver nitrate forms an explosive compound with tannic 
acid. 

Moulded Silver Nitrate 
(Argenti Nitras Fusus) 

(Lunar Caustic) 

This comes in hard white sticks in the form of pencils. 
It is used to destroy excessive granulation tissue and other 
tissues. 

Mitigated Silver Nitrate 
(Argenti Nitras Mitigatus) 

(Mitigated Caustic) 

This consists of one part of silver nitrate and two parts of 
potassium nitrate, fused into pencils like lunar caustic. 
Silver Oxide 0.03-0.12 gm. grs. |-ii 

(Argenti Oxidum) 

Organic Preparations 
New and Non-official Preparations 

These preparations are combinations of silver with al- 
buminous substances. They are therefore not as injurious 
(irritating) to the tissues, and can be used in stronger solu- 
tions as antiseptics. 



556 MATERIA MEDICA 

Argyrol 
Silver Vitellin 

This is a compound of silver oxide and proteids, contain- 
ing 20-25% of silver. 

It is used locally as an antiseptic and astringent to mucous 
membranes, in 10-25% solutions; which are not injurious to 
the tissues. Argyrol should be very carefully used, as it 
stains linen a dark brown color. 

Protargol 
Protein Silver Salt 

This is a compound of albumin and silver containing 
8.3% of silver. It is used as an antiseptic, and as an 
astringent on mucous membranes in 1 to 10% solutions; as 
irrigations in 1-1000 to 1-2000 and in the form of bougies 
and tampons in 5-10% solutions. 

Collargol (colloidal silver Crede) 0.06 gm. gr. i 

(Collargolum) 

This is a solution of very finely divided silver, in albumin, 
containing about 85% of silver. It is used as an antiseptic 
both locally, and injected into the blood. 

It is often given by direct injection into the veins, in cases 
of sepsis, in i% solutions. It is also used in the form of 
bougies, vaginal suppositories and dusting powders. 

Collargol Ointment 
(Unguentum Crede) 

This contains 15% of collargol. It is used principally in 
acute mastitis, or inflammation of the breast. 

About 2.0-4.0 gms. (grs. xxx-5i) are rubbed thoroughly on 
the skin. 

Albargin 
Gelatinose Silver 

This is a compound of gelatose with silver, which con- 
tains 13-15% of silver. 

Argentamin 

(Liquor Argentamini) 



ASTRINGENTS 557 

This is a watery solution of silver nitrate and ethylen 
diamine containing 10% of silver nitrate. It is used in 
J-4% solutions as an antiseptic in gonorrhoea. 

Argonin 
Silver Casein 

This is a compound of silver and casein, containing about 
4% of silver. It is used in i-20% solutions. 

Silver Citrate 
Itrol 

This is used as injections in 1-4000 to 1-1000 solutions 
as an antiseptic. 

Silver Lactate 
Actol 

This is used in 1-300 to 1-500 solutions as an antiseptic 
Cargentos. 

This is a 50% albuminous solution of silver with casein. 
It is used as an antiseptic, in the form of tablets, vaginal 
tampons, dusting powder, ointment or suppositories. 

Novargan (Silver Proteinate) 
(Argenti Proteinas) 

This is a compound of silver and albumin, containing 
10% of silver. It is used as a urethral injection in 15% 
solutions. 

Hegonon 

Silver Nitrate Ammonia Albumose 

This is an albumin silver preparation which contains 7% 
of silver. It is used in 1-6000 to 1-2000 solutions. 

Icthargan (Silver Icthyolate) 
Argenti Icthosulphonas 

This contains 30% of silver and 15% of sulphur. It 
is used in 1-4000 to 3% solutions. 

Sophol 

This is a compound of silver and methylen nucleic acid. 
It is used an antiseptic and astringent in 2-5% solutions, in 
inflammations of the eyes. 



558 MATERIA MEDICA 



ALUMINIUM AND ALUM 

Aluminium is a light metal. The only salt of aluminium 
which is used in medicine, is the aluminium and potassium 
sulphate, or alum. 

ACTION 

Local action: Applied to the skin, or mucous membranes, 
alum contracts the tissue by coagulating or hardening the 
cells. It checks the secretions of mucous membranes. It 
checks bleeding if applied to a bleeding point. 

Concentrated solutions cause redness and swelling and are 
injurious to the tissues. (Irritation.) 

Internal Action 

When taken internally, alum contracts the mucous mem- 
brane of the mouth, making it feel very dry. 

In the stomach and intestines: It contracts the mucous 
membranes and checks the secretions, causing constipation. 

Some of the alum is absorbed into the blood, is changed 
to an albuminate and is then said to stop bleeding. 

Poisonous Effects 

Large doses of alum cause vomiting, diarrhoea and col- 
lapse, which may be so severe as to cause death. 

In addition to the usual measures for metallic poisoning, 
which should be carried out, magnesium hydrate or ammo- 
nium carbonate should be given. 

Uses 

Alum is used principally as an astringent to contract mucous 
membranes. 

It is used as a gargle in 1 to 5% solutions. 

For douches, and as a lotion on the skin and other mucous 
membranes, it is used in |-1% solutions. 

Large doses of alum are occasionally used to produce 
vomiting. 



ASTRINGENTS 559 

Preparations 

Alum 0.3-1.0 gm. grs. v-xv 

(Alumen) 

This is aluminium and potassium acetate. Alum is very 
injurious to the teeth, and when given internally, it should 
be given through a glass tube. 

Dried Alum or Burnt Alum 
(Alumen Exsiccatum) 

This is alum which has been dried by heat. It absorbs 
moisture from the air. It is often combined with 1-5 parts 
of alcohol to harden the skin, and prevent bedsores. 

The other salts of aluminium, such as the aluminium 
acetate and the aluminium chloride are used as antiseptics. 

Aluminium Hydroxide 0.3-1.0 gm. grs. v-xv 

(Aluminii Hydroxidum) 

Aluminium Sulphate 
(Aluminii Sulphas) 

This is used only locally. 

Solution of Aluminium Acetate 
(Liquor Aluminii Acetas) 
(Burrow's solution) 

This is used in J-2% solutions as an antiseptic. 

New and Non-official Preparations 
Alumnol 
Alumini Naphtholsulphonas 

This is used as an astringent and mild antiseptic, in J-5% 
solutions, for dressings, gargles, douches, etc. 
It is used as a caustic in 10-20% solutions. 

ZINC (ZINCTJM) 

Zinc is a metal which forms salts, many of which are used 

in medicine. 

ACTION 

Local action: Applied to the skin or mucous membranes, 
weak solutions of zinc salts are soothing and contract the 



560 MATERIA MEDICA 

tissues. They lessen the secretion of mucous membranes, but 
this effect is very mild, however. Concentrated solutions 
cause redness and swelling and are injurious to the tissues. 
In powder form they destroy the tissue, acting as a caustic. 

Internal Action 

In the mouth: Zinc salts have a metallic taste, they con- 
tract the mucous membrane, check secretions, and make 
the mouth feel dry. 

In the stomach and intestines: They contract the mucous 
membranes, and check the secretions, thereby causing con- 
stipation. In larger doses, they cause nausea and vomiting. 

Absorption 

Part of the zinc salt which is taken, is absorbed into the 
blood as an albuminate, and it is then said to improve the 
nutrition of the nervous system. 

It is eliminated by the kidneys, saliva, bile, intestines, and 
milk. 

The zinc salts which do not readily dissolve, such as 
zinc carbonate or zinc oxide, are not so apt to cause nausea 
and vomiting. 

Poisonous Effects 

Excessive doses of zinc salts, cause: 

1. Vomiting and diarrhoea. 

2. Bloody urine. 

3. Jaundice. 

4. Collapse. 

5. Paralysis, convulsions, coma and death. 

Treatment 

1. Give alkalies such as lime water. 

2. Give tannic acid, in the form of strong tea. 

3. Milk, or albumin water, should be given to protect the 
mucous membrane. 

4. Treat the collapse with heart stimulants. 



ASTRINGENTS 561 

Chronic Zinc Poisoning 

Chronic zinc poisoning occasionally occurs among workers 
who handle zinc. It causes symptoms like those of lead 
poisoning. 

Uses 

Zinc sulphate is used to produce vomiting. The other zinc 
salts are used as astringents in various skin diseases and 
ulcers. 

Preparations 

Zinc Sulphate (as an emetic) 0.3-2.0 gms. grs. v-xxx 

(Zinci Sulphas) 

It is used as an eye wash in \-\% solutions and as an 
injection in gonorrhoea in 1-4% solutions. 

Zinc Oxide 0.12-0.5 gm. grs. ii-viii 

(Zinci Oxidum) 

Zinc Oxide Ointment 
(Unguentum Zinci Oxidum) 

This contains 1 part of zinc oxide to 4 parts of benzoinated 
lard. 

Precipitated Zinc Carbonate 0.12-0.5 gm. grs. ii-viii 

(Zinci Carbonas Precipitatus) 

Zinc Stearate 
(Zinci Stearas) 

This is used as a dusting powder on ulcers, and on various 
skin diseases. 

Zinc Stearate Ointment 
(Unguentum Zinci Stearas) 

This contains 50% of zinc stearate. 

Zinc Acetate 
(Zinci Acetas) 

This is used for injections and douches, in gonorrhoea. 

Zinc Chloride 
(Zinci Chloridum) 

This is a white powder which is moulded into pencils. 



562 MATERIA MEDICA 

It absorbs moisture from the air. It is used to destroy 
tissues. (Caustic action.) It is an ingredient of many 
" cancer cures/ ' which destroy the cancerous tissue, when 
applied as an ointment. 

Solution of Zinc Chloride 
(Liquor Zinci Chloridum) 

This contains about 36% of zinc chloride, and is used as a 
disinfectant for sinks and toilets. 

Burnett's disinfecting fluid 

This contains about 13-30 c.c. of zinc chloride. 

Zinc Iodide 0.06-0.12 gm. grs. i-ii 

(Zinc Iodidum) 

It is used locally as a caustic and to increase the growth of 
tissue. 

Zinc Valerate 0.06-0.12 gm. grs. i-ii 

(Zinci Valeras) 

Zinc Bromide 0.06-0.12 gm. grs. i-ii 

(Zinci Bromidum) 

This is used to lessen nervousness and the twitchings of 
chorea and epilepsy. 

COPPER (CUPRUM) 

Copper is a metal, many salts of which are occasionally 
used as drugs. 

ACTION 

Local action: Applied to the skin or mucous membranes, 
copper salts contract and harden the tissues by coagulating 
the proteids of the cells. They check the secretions of 
mucous membranes. Concentrated solutions cause redness 
and swelling of the tissues (irritation) and may even destroy 
tissue. 

Internal Action 

In small doses, copper salts contract and lessen the secre- 
tion of the mucous membrane of the mouth, stomach and 
intestines. In larger doses, they cause nausea, vomiting, and 
profuse flow of saliva. 



ASTRINGENTS 563 

Poisonous Effects 

Overdoses of copper salts cause: 

1. Violent abdominal pain. 

2. Nausea, vomiting and diarrhoea. 

3. Jaundice. 

4. Collapse. 

5. Convulsions, paralyses, coma and death. 

The treatment is the same as for other metallic poisoning. 
Chronic poisoning causes symptoms similar to those of lead 
poisoning. 

Preparations 

Copper Sulphate (blue vitriol or blue stone) 
(Cupri Sulphas) as an astringent 0.015-0.12 gm. grs. J-ii 
as an emetic 0.3 -0.6 gm. grs. v-x 

It is used principally to contract the granulations which 
form in the eyelids in trachoma, an infectious disease of the 
eyelids. 

It is also used to produce vomiting, as an astringent, 
and occasionally to destroy tissue (escharotic action). 

Copper Citrate (not official) 
(Cupricum Citricum) 

This contains about 35% of copper. It is used as an 
astringent in 5-10% ointments. 

BISMUTH (BISMUTHUM) 

Bismuth is a crystalline metal. Many of its insoluble 
salts are used as medicines. 

ACTION 

Local action: Applied to the skin or ulcers, Bismuth salts 
contract the tissues. They are antiseptic and soothing. 
Mucous membranes are contracted, soothed and their secre- 
tions checked. 

Internal Action 

In the stomach and intestines: It contracts the mucous 
membranes, it coats and protects them from injurious 




564 MATERIA MEDICA 

substances and lessens their secretions, thereby producing 
constipation. It also acts as an antiseptic, checking the 
growth of bacteria. 

Most of the bismuth passes out in the stools, which turn 
black by the formation of bismuth sulphide. A very small 
amount is absorbed, but this produces no effects. 

Poisonous Effects 

Bismuth poisoning occasionally results when it is used for 
a long time; especially in the form of dressings. Such appli- 
cations are more apt to cause poisonous symptoms than its 
internal administration. 

Symptoms 

The symptoms appear very slowly and resemble those of 
mercury poisoning. They are: 

1. Profuse flow of saliva. 

2. Swelling of the gums, tongue and throat, often with 
destruction of the soft palate, and other portions of the 
mucous membrane of the mouth. 

3. Vomiting and diarrhoea. 

4. Albumin in the urine. 

The symptoms usually disappear when the dressings are 
removed. 

Uses 

Bismuth salts are used as dusting powders on the skin, as 
astringents, as antiseptics and to promote healing of ulcers, 
and sinuses. 

They are principally used to coat, protect and heal ulcers 
of the stomach, and to check diarrhoea. They are often 
used to lessen nausea and vomiting. 

Large quantities of bismuth pastes are often given to coat 
the mucous membranes of the oesophagus, stomach and 
intestines to enable an X-ray picture to be taken. The 
bismuth cannot be penetrated by the X-rays, so that the 
organ containing the bismuth produces a dark shadow on 
the picture. 



ASTRINGENTS 565 

Preparations 

Bismuth Subnitrate 0.3-2.0 gms. grs. v-xxx 

(Bismuthi Subnitras) 

Bismuth Subcarbonate 0.3-2.0 gms. grs. v-xxx 

(Bismuthi Subcarbonas) 

Bismuth and Ammonium Citrate 0.12-0.3 gm. grs. ii-v 
(Bismuthi et Ammonii Citras) 

This is more injurious to the tissues than the other prepara- 
tions. 

Bismuth Subgallate 0.3-1.3 gm. grs. v-xx 

(Bismuthi Subgallas) 

(Dermatol) 

New and Non-official Preparations 

Bismuth Beta Naphtholate 1.0-5.0 gms. grs. xv-lxxv 

(Bismuthi Beta Naphtholas) 

This is used to check diarrhoea and as an intestinal anti- 
septic. 

Bismuth Subcarbonate Preparations 

Cremo Bismuth 4.0-16.0 c.c. 5i-iv 

(Mistura Bismuthi Subcarbonatis Hydrati) 

Lac Bismo 4.0-16.0 c.c. 5i-iv 

(Mistura Bismuthi) 

This is a mixture of bismuth hydroxide and bismuth 
subcarbonate. 

Bismuth Subgallate Preparations 

Airol (Bismuth Oxyiodogallate) 
(Bismuthi Iodosubgallas) 

This is a combination of bismuth oxyiodide and gallic 
acid. It liberates iodine and is used as a local application 
to wounds, in 10% solutions in glycerin or in a 10 or 20% 
ointment. 

Bismal 0.12-0.3 gm. grs. ii-iv 

(Bismuthi Methylen Digallas) 



566 MATERIA MEDICA 

Tannismuth 0.3-0.6 gm. grs. v-x 

(Bismuthi Bitannas) 

This contains about 17 to 21% of bismuth. 

Bismon (Colloidal Bismuth Oxide) 0.5 gm. grs. viii 

This is an albuminous solution containing 20% of bismuth. 

Bismuth and Iron Citrate 0.3-0.6 gm. grs. v-x 

(Bismuthi et Ferri Citras) 

This is used for anaemia with gastric disturbances. 

Crurin Purum 

(Quinolin Bismuth Sulphocyanate) 

This is used principally as an antiseptic in gonorrhoea and 
in ulcers of the leg in 1-200 solutions. 

Bismuthal 

This is a mixture of pepsin, hydrochloric acid, and bis- 
muth. 

Xeroform 1.0-3.0 gms. grs. xv-xlv 

(Bismuthi Tribromiphenolas) 

This is used principally as an antiseptic in ulcers of the 
leg, eczema, and as an intestinal antiseptic. 

CERIUM OXALATE 

Cerium oxalate is a salt of cerium, a crystalline metal, 
which resembles bismuth. 

It is used to check vomiting; in pregnancy, sea-sickness, 
and in other conditions. Its mode of action is unknown. 

Preparations 

Cerium Oxalate 0.12-0.6 gm. grs. ii-x 

(Cerii Oxalas) 



PART VI.— LOCAL REMEDIES, SERUMS AND 
ORGANIC SUBSTANCES 

CHAPTER XXII 

ANTISEPTICS AND LOCAL REMEDIES 

ANTISEPTICS 

Antiseptics or disinfectants are drugs which check the 
growth of bacteria (bacteria are very small unicellular micro- 
scopic organisms, many of which cause disease). They 
are divided into two groups; germicides and antiseptics. 

Germicides or disinfectants are drugs which destroy bac- 
teria. Antiseptics are drugs which check the growth of 
bacteria; usually by making the fluid in which they grow 
unfit for them to live in. Deodorants are drugs, most of 
which are also antiseptics, that destroy unpleasant odors. 

The antiseptics, while checking the growth of bacteria, 
are also injurious to the tissue cells. They must therefore 
be used in such weak solutions that will affect only the bac- 
teria, and do little harm to the tissues. Antiseptics can be 
classified according to their practical use in the following 
way: 

(a) Local Antiseptics 

1. Disinfectants for rooms. 

2. Disinfectants for sinks, clothing, excreta, etc. 

3. Antiseptics for the hands. 

4. Antiseptics for the skin. 

5. Antiseptics for wounds, ulcers, sinuses, etc. 

6. Antiseptics for mucous membrane lined cavities. 

(6) Antiseptics acting after absorption 

1. Antiseptics acting on the lungs. 

2. Genito-urinary antiseptics. 

567 



568 MATERIA MEDICA 



DISINFECTANTS FOR ROOMS 

FORMALDEHYDE 

Formaldehyde is a gas obtained by oxidizing wood alcohol. 
A solution containing 40% of formaldehyde gas is called 
formalin. 

ACTION 

Antiseptic Action 

Formaldehyde gas vigorously destroys bacteria (germi- 
cide) and checks their growth (antiseptic). It also neu- 
tralizes unpleasant odors (deodorant). 

Local action: Applied to the skin or mucous membranes, 
formalin hardens the tissues and checks the growth of bac- 
teria on the surface. 

When formaldehyde gas is inhaled, it causes stinging and 
prickling sensations in the nose, with a profuse flow of mu- 
cus from the nose, a flow of tears from the eyes, secretion of 
saliva, and excessive coughing, with profuse expectoration. 

Internal Action 

When very small doses of formalin are given internally, it 
causes nausea and vomiting, lessens the digestion of food 
and makes the pulse somewhat slower and weaker. 

Poisonous Effects 

Poisoning by large doses of formalin or formaldehyde gas 
occurs occasionally, and produces the following symptoms: 

1. Nausea and vomiting. 

2. Diarrhoea. 

3. Shortness of breath and cyanosis (due to contracting 
the red blood cells and the formation of haematin in the 
blood). 

4. Collapse, coma, convulsions and death. 
The best antidote is ammonia water. 



ANTISEPTICS AND LOCAL REMEDIES 569 

Uses 

Formaldehyde gas is used principally to fumigate rooms and 
to disinfect clothing. It is generated in the following ways : 

1. By heating a solution of formalin in the room; 150 c.c. 
of formalin is necessary to disinfect a room of 1000 c.c. of 
space. 

2. By heating paraform, a solid substance which liberates 
formaldehyde gas. There are numerous lamps on the 
market which liberate formaldehyde gas in this way. 

3. By a specially constructed apparatus for generating 
formaldehyde gas. The gas is allowed to enter the room by 
a rubber tube which is inserted in the key-hole. 

When disinfecting with formaldehyde gas, the cracks in 
the door should be stuffed with cotton and the room should 
be kept closed for 24 hours. The unpleasant odor is re- 
moved by sprinkling ammonia water about the room. 

Formalin is used in 1-200 solutions to sterilize instruments. 
There are a number of instrument sterilizers on the market 
which generate formaldehyde gas and sterilize the instru- 
ments in this way. Formalin has also been used as a mouth 
wash and as a douche in 1-500 to 1-1000 solutions. 

It is occasionally used as a preservative for milk and other 
foods. A 4% solution of formalin is used to preserve tissues 
for microscopic examination. 

Preparations 

Formalin 

(Liquor Formaldehydi) 

This contains 37% of formalhyde gas. 

Paraform or Paraformaldehyde 0.3-1.0 gm. grs. v-xv 

(Trioxymethylene) 

This is a solid substance which liberates formaldehyde 
gas on heating. It is used locally to destroy warts and also in- 
ternally as an antiseptic. 

There are a number of other preparations which liberate 
formaldehyde gas in the body; they will be described under 
their particular use. 



570 MATERIA MEDICA 



SULPHUR DIOXIDE 



Sulphur dioxide or sulphurous acid is a gas which is 
formed when sulphur is burned. It is one of the oldest dis- 
infectants in medicine; being used since 1771. It is an ex- 
cellent disinfectant for rooms; but it is apt to injure clothing, 
linens, carpets, etc. 

Uses 

Sulphur dioxide is formed when suiphur candles or sulphur 
masses are burnt in the room. The sulphur should be placed 
in a metal or porcelain dish placed in a basin of water, and 
the sulphur should then be burned. All cracks and key-holes 
in the room should be tightly closed. 

CHLORINE (CHLORUM) 

Chlorine is an element which occurs in the form of a green- 
ish yellow gas. It is obtained from sea salt, and a number 
of its compounds are used as disinfectants. 

Chlorine, bromine, and iodine, are three closely related 
elements called halogens, since they are all obtained from the 
sea; thus; chlorine from sea salt, bromine from sea water, 
and iodine from sea weeds. 

ACTION 

Antiseptic action 

Chlorine gas is one of the most efficient disinfectants 
known; especially when it is used in the presence of moisture. 
The chlorine combines with the hydrogen of the water, thus 
setting oxygen free. The oxygen then destroys the bacteria. 
A 0.3% solution of chlorine will destroy even the spores of 
bacteria in about three hours. Chlorine also removes obnox- 
ious odors very readily (deodorant). 

Action on the Body 

Local action: Concentrated solutions of chlorine gas 
redden the skin and produce blisters if the solution is pre- 



ANTISEPTICS AND LOCAL REMEDIES 571 

vented from evaporating. On mucous membranes it in- 
creases the secretions. 

Internal Action 

In the mouth chlorine usually causes profuse secretion 
of saliva. In the stomach and intestines it increases the 
secretions. Inhalation of chlorine gas usually makes the 
patient cough and increases the secretions of the bronchi. 

Poisonous Effects 

If large doses of chlorine solutions are swallowed, the 
following effects are produced : 

1. Redness and destruction of the tissues around the 
mouth. 

2. Abdominal pain. 

3. Nausea and vomiting. 

4. Collapse (cold moist skin, rapid thready pulse, slow 
and shallow breathing.) 

These symptoms are due to the formation of excessive 
amounts of hydrochloric acid in the stomach. 

If the gas is inhaled, the patient has violent coughing; 
often with bloody expectoration. 

The symptoms should be treated with alkalies, such as 
sodium bicarbonate; for the pain, morphine should be given; 
as well as albumins, milk, or flour to protect the mucous 
membrane of the stomach. 

Uses 

Chlorine is used principally to disinfect stools and urine. 
It is used in the form of chlorinated lime; which liberates 
chlorine gas. It has a special advantage in removing foul 
odors. Concentrated chlorine gas, liberated by a specially 
constructed generator is used to disinfect rooms. It is very 
efficient; but it bleaches various dyed materials. It is pre- 
pared by placing a dish containing equal parts of black oxide 
of manganese and salt in the center of the room. To this 
is added one tablespoonful of strong sulphuric acid diluted 
one third. Enough chlorine gas will thus be formed to 
disinfect the room. 



572 MATERIA MEDICA 

Preparations 
Chlorine water 
(Liquor chlori compositae) 

This is a solution containing 4 parts of chlorine gas to 
1000 c.c. of water. 

It should be freshly prepared, as it otherwise contains 
hydrochloric acid. 

Chlorinated Lime or Bleaching Powder 
(Calx Chlorinata) 

This is a grayish white powder containing 35% of chlorine 
gas when fresh. It is sometimes erroneously called chloride 
of lime. A fresh powder forms a clear solution; otherwise 
the solution becomes turbid. 

Solution of Chlorinated Soda 0.6-1.3 c.c. m. x-xx 

(Liquor Sodae Chlorinatae) 
(Labarracque's or Javelle's Solution) 

This is a solution made from chlorinated lime and sodium 
carbonate. It contains sodium hypochlorite and sodium 
chloride. It liberates about 2^% of chlorine gas and is 
used for cleansing medicine droppers, douche nozzles and 
other small utensils. It is especially valuable to remove 
stains. It is occasionally given internally in half a tumbler 
of warm milk. 

BROMINE (BROMUM) 

Bromine is a liquid element obtained from sea water. 
Its action is similar to that of chlorine with the following 
differences : 

1. It is more destructive to the tissues. It is occasionally 
used to cauterize infected wounds (escharotic action). 

2. When given internally in the form of bromides it lessens 
the activity of the brain (see Bromides). 

DISINFECTANTS FOR SINKS, CLOTHING, ETC. 

For this purpose formalin is occasionally used in 10% 
solutions. 



ANTISEPTICS AND LOCAL REMEDIES 573 

CARBOLIC ACID (PHENOL) 

Carbolic acid or phenol is a crystalline solid substance 
which readily absorbs moisture from the air. It is made 
by distilling coal tar; it dissolves readily in water, alcohol or 
glycerine. 

Antiseptic Action 

Carbolic acid destroys all living tissues (protoplasm). 
In weak solutions (2-5%) it checks the growth of all bacteria 
except their spores. It is the most efficient antiseptic known. 

Action on the Body 

Local action: Concentrated solutions destroy the skin by 
hardening or coagulating the proteids of the cells. This 
forms a white crust which becomes red and shiny. The 
crust falls off in a few days, leaving a light brown area. 
Weak solutions (2-5%) produce a feeling of warmth and 
tingling followed by numbness and contraction of the skin. 
Applied to wounds, carbolic acid causes pain and redness 
with the formation of a white pellicle of coagulated albumin. 

Local applications of carbolic acid solutions, if prevented 
from evaporating, as when applied in the form of a wet 
dressing, often destroy the skin and deeper tissues (gan- 
grene) . Gangrene of a finger or other part of the body has 
occasionally resulted from continued use of such wet dress- 
ings. For this reason its use as a wet dressing has been 
given up. On mucous membranes: carbolic acid checks the 
growth of bacteria if applied in weak solutions. 

Strong solutions, if applied for some time, destroy the 
tissues; and if the area over which it is applied is extensive, 
collapse may result. 

Internal Action 

Carbolic acid is never given internally. When taken with 
suicidal intent it produces effects after absorption (see 
poisonous effects). There are, however, a number of drugs, 
such as salol, which form small amounts of carbolic acid 



574 MATERIA MEDICA 

in the intestines. These then act as antiseptics, checking 
the growth of bacteria in the intestines. In this way they 
lessen the decomposition of the waste products in the intes- 
tines (putrefaction). 

Action after Absorption 

When a small quantity of carbolic acid is absorbed, 
either from wet dressings applied to wounds or when formed 
in the intestine, it occasionally produces the following effects: 

1. It increases the secretion of saliva. 

2. It increases the flow of urine. The urine has a char- 
acteristic smoky dark green color which soon turns brown 
or even black. 

3. Occasionally, the patient becomes somewhat drowsy, 
due to the lessened action of the brain, (depression). 

4. The breathing becomes somewhat deeper and faster 
and the pulse slower and weaker. 

Excretion 

In cases where a small quantity of carbolic acid is ab- 
sorbed, it is rapidly eliminated by the urine in the form of 
various compounds which give the urine a characteristic 
dark green color. 

Poisonous Effects 

Acute poisoning from carbolic acid is not an infrequent 
occurrence as a result of attempts at suicide, since it is the 
easiest poison to obtain. 

Symptoms 

If a large quantity of carbolic acid is taken, the patient 
becomes unconscious and dies within a few minutes from 
a sudden paralysis of the heart and respiration. This is 
probably due to the sudden destruction of a large area of 
mucous membrane and the resulting collapse. 

If smaller quantities are taken, the following symptoms 
appear in the order of their onset: Some of these symptoms 
also occasionally result from the continued use of wet dress- 
ings. 



ANTISEPTICS AND LOCAL REMEDIES 575 

1. Pain around the mouth and lips, and in the stomach. 
The lips and mouth are blanched. 

2. Nausea and vomiting, the vomited matter containing 
mucous. 

3. Headache, dizziness, and noises in the ears. 

4. Drowsiness and depression. 

5. Collapse: rapid thready pulse, cold moist skin, the 
pulse falls to 40 or 50 per minute, the breathing becomes 
irregular, often snoring in character. Toward the end, the 
breathing becomes difficult and shallow, sometimes gasping, 
and because of the shallow breathing, the patient becomes 
cyanotic. 

6. Finally, the patient goes into stupor, and coma, and 
then dies from paralysis of the respiration, in about one to 
ten hours. 

Occasionally, convulsions occur just before death. A very 
characteristic symptom of carbolic acid poisoning is the 
dark green color of the urine, and the odor of the acid on the 
breath. The fatal dose is usually about 5i-iv. 

Treatment 

1. Wash out the stomach with 50% alcohol. 

2. Give one of the following drugs as an antidote: 

(a) Magnesium sulphate (Epsom salts) . 

(b) Sodium sulphate (Glauber's salts). 

(c) Lime water and milk. 

About 5i of one of the salts dissolved in a glass of water. 
They form sulphocarbolates; harmless salts of carbolic acid. 

3. Give alcohol in the form of whiskey or brandy, or even 
50% solutions of alcohol. The alcohol neutralizes the 
carbolic acid; its mode of action is unknown. (A carbolic 
acid burn is readily neutralized, if followed immediately 
by the application of alcohol) . 

4. Protect the mucous membrane of the mouth and 
oesophagus with albumin water, flaxseed tea, etc. Do not 
give oils or glycerine as they help to absorb the carbolic acid. 

5. Treat the collapse with heart stimulants such as 
caffeine, strychnine, atropine, etc., and keep the patient 
warm. 



576 MATERIA MEDICA 

Uses 

Carbolic acid was the first substance used as an antiseptic. 
It was formerly sprayed in operating rooms to disinfect the 
air, since most infections were supposed to come from the 
air. Later knowledge of the nature of infections has proven 
the worthlessness of this use. At the present time carbolic 
acid is used : 

1. To disinfect sinks, toilets, sputum cups, clothing, etc., 
in 2-5% solutions. The articles must be soaked in carbolic 
acid for a half to several hours. 

2. To disinfect the sick room by washing the walls and 
furniture. The fumes are often inhaled from such use and 
cause slight poisonous symptoms. 

3. It is occasionally given internally to check vomiting, 
and as an intestinal antiseptic to check fermentation in the 
intestines. 

Preparations 

Carbolic Acid: For internal use 0.03-0.2 gm. grs. f-iii 
(Phenol) 

This comes in crystals which readily take up water (hy- 
groscopic). It is used principally for its destructive action 
on tissues (corrosive action). 

Liquid Carbolic Acid: For internal use 0.06-0.2 c.c. m. i-iii 
(Phenol Liquefactum) 

This contains 90% of carbolic acid. 

Glycerite of Phenol 0.12-0.3 c.c. m. ii-v 

(Glyceritum Phenolis) 

This contains 20% of phenol dissolved in glycerine. 

Carbolic Acid Ointment 
(Unguentum Phenolis) 

This contains 5% of carbolic acid. 

As an antiseptic carbolic acid is used in 2-5% solutions. 

Carbolic Acid Derivatives 
Cresols 
There are a number of oily substances which are exten- 



ANTISEPTICS AND LOCAL REMEDIES 577 

sively used as antiseptics, and are chemically closely related 
to carbolic acid. They are called cresols and are obtained 
from tars and other crude similar substances. The three 
cresols which are principally used are: 

Metacresol 

Orthocresol 

Paracresol 
Because they are oily solutions, they do not dissolve 
readily in water and are used in emulsions or soapy solu- 
tions. The antiseptic, physiological and poisonous actions 
of all of them are like that of carbolic acid. Metacresol is 
the best antiseptic and the least poisonous of the group. 

Preparations 

Cresol 0.06 c.c. m. i 

This is a mixture of all the cresols. 

Compound Solution of Cresol 
(Liquor Cresolis Compositus) 

This is a 50% solution of cresol in soap solution. It is 
used diluted as a disinfectant. 

New and Non-official Preparations 
Tricresol 

This is a mixture of all the three cresols. 

Kresamine 
(Ethylenediamine Tricresol) 

This contains 25% of tricresol and is used as an antiseptic 
like phenol and as an ointment for skin diseases. 

Creolin 

This is an emulsion of cresol. It is used in 1-5% solutions 
to disinfect sinks, excreta, toilets, etc. It is also used in J 
to 1% solutions for vaginal douches, and for bladder irriga- 
tions. 

Lysol 

This is a 50% solution of cresols dissolved in soap. It 



578 MATERIA MEDICA 

forms a frothy solution in water and is used for douches and 
other irrigations in i to 1% solutions. 

Lysoform 

This is a combination of lysol and formaldehyde which 
is used as a disinfectant in 5 to 10% solutions. 

Solveol 
Solutol 

These are solutions of cresols which have been made 
soluble by the addition of salts. 

Other antiseptics used to disinfect clothing and excreta 
are: 

Zinc Sulphate 

This acts as a disinfectant by precipitating the proteids 
of the bacteria. For this purpose the following solution is 
used: 

Zinc Sulphate 60.0 gms. 5ii 

Sodium Chloride 120.0 gms. 5iv 

These salts are dissolved in one gallon of water, and the 
clothes are soaked in this solution for 4-6 hours. Zinc 
chloride is occasionally used as a disinfectant, but it is not 
very reliable and is not therefore frequently used. 

Iron Sulphate 
(Ferri Sulphas) 

This acts as an antiseptic by precipitating the proteids of 
the bacteria. It acts more readily when the bacteria are 
together with organic matter, such as pus or blood. It is 
used principally to disinfect the stools; an equal amount of 
the solution being used. 



ANTISEPTICS USED TO DISINFECT THE HANDS 

The following antiseptics are used principally to disinfect 
the hands of the surgeon or nurse when performing or assist- 
ing at an operation or when dressing wounds. To obtain 



ANTISEPTICS AND LOCAL REMEDIES 579 

the maximum antiseptic action the hands should be kept in 
the solution for about five to fifteen minutes. 

Bichloride of Mercury or Corrosive Sublimate 
(Hydrargyri Chloridum Corrosivum) 

This is used as an antiseptic in solutions of 1-10,000 to 
1-1000. Continued use of bichloride is apt to be injurious 
to the skin, causing redness and itching. The solution should 
always be fresh, as the bichloride combines with the bacteria 
and makes old solutions inactive. It cannot be used to 
disinfect instruments as it turns them black (corrodes). 

Mercuric Cyanide 
(Hydrargyri Cyanidum) 

This is used in solutions of 1-4000 to 1-2000 like bichloride, 
but it does not corrode instruments and does not injure the 
skin. 

Mercuric Oxy cyanide 
(Hydrargyri Oxycyanidum) 

Sublamine 

(Mercuric Sulphate Ethylendiamine) 

This is similar to calomel. It is used in solutions of 1-1000 
to disinfect the hands, and for irrigations. It is also given 
in 3-4% solutions intramuscularly for syphilis. 

Alcohol 

This is used in 50-70% solutions as a very efficient anti- 
septic for the hands. Stronger solutions are not as active 
because they harden the capsules of the bacteria and do not 
penetrate the bacteria themselves. 

" Lime and Soda " 

A very common method of disinfecting the hands is by 
rubbing chlorinated lime and sodium carbonate together in 
the hands. Chlorine gas is liberated in this way which then 
disinfects the hands. 



580 MATERIA MEDICA 



ANTISEPTICS USED TO DISINFECT THE SKIN 

IODINE (IODUM) 

Iodine is a non-metallic element obtained from the ashes 
of sea weeds. Iodine itself is not used in medicine, but 
various solutions and compounds of it are frequently em- 
ployed. 

Antiseptic Action 

Iodine checks the growth of bacteria, having a marked 
disinfectant action. It has been used very extensively for the 
last few years to disinfect the skin in preparation for opera- 
tions. It is of especial value for this purpose since it also 
contracts and hardens the skin so that bacteria cannot be 
carried from the skin to the deeper tissues of the wound. 
It should not be applied in a concentrated solution or when 
the skin is moist, as it is then apt to cause blisters or even 
to destroy the deeper tissues. 

Action on the Body 

Local action: Iodine stains the skin a dark brown color 
and makes it red and warm. Strong solutions cause blis- 
ters and may even destroy the skin. It is also slightly ab- 
sorbed from the skin. 

On mucous membranes: It produces redness, smarting and 
increases the secretions. 

Internal Action 

When taken internally, it causes nausea and occasion- 
ally vomiting and diarrhoea. It is readily absorbed from the 
stomach in a few minutes. 

Action after Absorption 

The iodine combines in the blood with the sodium or potas- 
sium salts; thus forming iodides. The effects then produced 
are like those of the iodides. (See page 487.) They increase 
the secretion of all the secretory glands, such as the saliva, 
the mucous from the nose and bronchi. They also increase 



ANTISEPTICS AND LOCAL REMEDIES 581 

the absorption of newly formed tissues (they are often given 
to reduce enlarged lymph nodes). At the same time, by in- 
creasing the secretion of the thyroid gland, the pulse be- 
comes more rapid and the patient becomes quite nervous. 

Excretion 

Iodine is eliminated from the body in a few minutes; by 
all the secretions as well as by the kidneys. 

Poisonous Effects 

Acute poisoning from iodine occurs very rarely; usually 
from the injection of iodine into cysts in order to obliterate 
them, and occasionally from iodine taken with suicidal intent. 

Symptoms 

1. Nausea and continuous vomiting. The vomited matter 
contains iodine which turns blue if starch is also present. 

2. Diarrhoea. 

3. Cyanosis. 

4. Collapse, rapid thready pulse, cold moist skin, slow 
shallow breathing and dilated pupils. Death usually occurs 
in a few days. 

Treatment 

Give boiled starch as an antidote. Protect the mucous 
membrane with albumin water, milk or other protecting 
drinks; treat the collapse with heart stimulants; such as 
caffeine, atropine, strychnine, etc. 

Chronic Poisoning " Iodism " 
Continued use of iodine often causes the following symp- 
toms. 

1. Skin eruptions, beginning at the site of application; 
consisting of areas of redness. 

2. Increased secretion of mucous from the nose and 
bronchi. 

3. Rapid pulse. 

4. Nervousness and tremors of the fingers. 



582 MATERIA MEDICA 

The symptoms usually disappear when the iodine applica- 
tions are stopped. 

Preparations 

Tincture of Iodine 0.2-0.5 c.c. m. iii-viii 

(Tinctura Iodi) 

This contains 7% of iodine and 5% of potassium iodide 
in alcohol. 

Compound Iodine Solution 0.2-0.8 c.c. m. iii-xii 

(Liquor Iodi Compositus) 
(LugoPs Solution) 

This contains 5% of iodine dissolved in 10% of potassium 
iodide solution. 

Iodine Ointment 
(Unguentum Iodi) 

This contains 4% of iodine. 

Sulphur Iodide 
(Sulphuris Iodidum) 

This is a mixture of iodine and sulphur. 

Losophan (Not official) 

This is a preparation containing 78% of iodine which is 
used as a powder or in 10-20% solutions. 

SULPHUR 

Sulphur is an element which occurs in the form of a yellow 
powder. It is found in volcanoes and also as compounds of 
various metals forming sulphides (a sulphide is a compound 
of sulphur with another element or with a metal). The 
action of sulphur is due to the sulphides which it forms in the 
body. 

ACTION 

Local action: Applied to the skin it slightly checks the 
growth of bacteria and destroys parasites (parasiticide). 
It stains silver objects black, because of the silver sulphide 
which it forms. 



ANTISEPTICS AND LOCAL REMEDIES 583 

Internal Action 

When taken internally, the sulphides which it forms in the 
intestines increase the secretions; producing mild movements 
of the bowels. It is eliminated from the body as sulphides 
by the expired air; to which it gives a very foul odor, and 
also by the stools. 

Poisonous Effects 

Continued use of sulphur often causes anaemia, great 
wasting and tremors of the muscles. 

Preparations 

Sulphur Ointment 
(Unguentum Sulphuris) 

This contains 15% of sublimed sulphur with benzoin and 
lard. 

Liver of Sulphur 
(Potassa Sulphurata) 

This is a preparation of sulphur which is often used in 
ointments and baths in doses of 51-vi of sulphur to a gallon 
of water. This substance is very destructive to tissues 
(corrosive). 

Thilanin (Not official) 

This is a mixture of lanolin and sulphur containing about 
5% of sulphur. For other preparations of sulphur used as 
cathartics see page 100. 



ICHTHYOL (Not official) 

Ichthyol is a substance obtained from a peculiar bitumi- 
nous mineral found in the Tyrol. It is formed by the deposits 
of fossil fish and contains about 10% of sulphur. 

ACTION 

Applied to the skin ichthyol is slightly antiseptic and 
causes redness. When given internally it acts as an antisep- 



584 MATERIA MEDICA 

tic in the intestines. In large doses it is apt to cause slight 
nausea and vomiting. The same effects occasionally result 
when it is absorbed from the skin. 

Ichthyol is used as an antiseptic and mild irritant in 
various skin affections. 



Preparations 

Ichthyol 0.2-2.0 c.c. m. iii-xxx 

(Ammonii Icthosulphonas) 

This is a reddish brown substance which dissolves readily 
in water. It is used in the form of watery solutions or oint- 
ments in from 1-20% solutions. 

Sodium Ichthyol 
(Sodii Icthosulphonas) 

Calcium Ichthyol 
(Calcii Ichthosulphonas) 

Ichthargan 

(Argenti Ichthosulphonas) 

This contains 30% of metallic silver and 15% of sulphur. 
It combines the action of both. 

Ferrichthyol 1.0-2.0 gms. grs. xv-xxx 

Ichthalbin 0.6-1.3 gms. grs. x-xx 

(Ichthyol Albuminate) 

Ichthoform 0.6-2.0 gms. grs. x-xxx 

(Ichthyol Formaldehyde) 

This is given in gruel or cocoa as an intestinal antiseptic. 
It is also used to disinfect rooms, for irrigations and in 
douches. 



THIOL (THIOLUM) (Not official) 

Thiol is an artificial substance formed by the action of 
sulphur on the tar obtained from brown coal. Its action is 
like that of ichthyol. It is used in the treatment of burns. 



ANTISEPTICS AND LOCAL REMEDIES 585 

Preparations 
Dry Thiol 
(Thiol Siccum) 

This contains 8% of sulphur and is used as a dusting pow- 
der on wounds. 

Liquid Thiol 
(Thiol Liquidum) 

This contains about 2% of sulphur and is used in various 
skin diseases. 

Tumenol 1 . 

(Tumenol Venale) } Tumeno1 Ammonium 

These are artificial preparations made from the same 
mineral as ichthyol. They act like ichthyol and are used 
in solutions of from 5-20%. 

RESORCIN 

Resorcin or resorcinol is a chemical substance made from 
carbolic acid. 

ACTION 

The action of resorcin is like that of carbolic acid. 
Local action: Applied to the skin it checks the growth of 
bacteria; acting as an antiseptic and disinfectant. 

When given internally it produces the following effects : 

1. It checks the growth of bacteria in the stomach and 
intestines. 

2. It reduces temperature, and increases perspiration. 

3. It makes the pulse slower. 

Overdoses of resorcin produce the same poisonous effects 
that result from carbolic acid poisoning. (See page 574.) 

Uses 

Resorcin is used principally as an antiseptic in skin dis- 
eases, such as dandruff, baldness, etc. It is occasionally 
used as an intestinal antiseptic and to reduce temperature. 



586 MATERIA MEDICA 

Preparations 

Resorcinol 0.3-0.6 gms. grs. v-x 

(Metadioxybenzol) 

Externally this is used in 5-10% solutions. 

Euresol (Not official) 
(Resorcin Monacetate) 

This acts like resorcin and is especially valuable in dan- 
druff and baldness. 

Pyrocatechin and Hydroquinoine are the derivatives of car- 
bolic acid which are rarely used in medicine. 

PYROGALLOL 

Pyrogallol or pyrogallic acid is a light crystalline substance 
made by heating gallic acid. 

ACTION 

The action of pyrogallol is similar to that of carbolic acid. 

Applied to the skin of mucous membranes it checks the 
growth of bacteria, acting as an antiseptic; it destroys par- 
asites and produces redness of the skin. It usually stains the 
skin or clothing a dark brown color. 

Pyrogallol is occasionally absorbed from the skin and pro- 
duces poisonous symptoms which resemble those of carbolic 
acid poisoning. (See page 574.) 

Preparations 

Pyrogallol 
(Pyrogallic Acid) 

This is used in the form of 5-20% ointments. 

New and Non-official Antiseptics 
Antiformin 

This is a strongly alkaline solution of sodium hypochlorite. 
It rapidly dissolves the bodies of all bacteria, except the 
tubercle bacilli; it dissolves all secretions such as sputum, 



ANTISEPTICS AND LOCAL REMEDIES 587 

and also destroys unpleasant odors. It is therefore a dis- 
infectant, antiseptic and deodorant. It is said to be a 
stronger disinfectant than carbolic acid. It is also used to 
test the sputum and other secretions for tubercle bacilli. 
Antiformin is used externally in 2-10% solutions, and as a 
spray in 1-1000 solutions. 

Anthrasol 

This is a colorless coal tar which has been freed from pitch, 
coloring matter and other substances and is then mixed with 
juniper tar. It is used as an antiseptic for the skin, to 
destroy parasites and to soothe the skin. It is usually given 
in ointments of 5-30% in various skin diseases. 

Afridol 

This is an artificial chemical substance used to disinfect 
the hands, as a surgical antiseptic, and for various skin 
diseases. It usually comes in the form of a soap containing 
about 4% of afridol. 

Chinosol 

Chinosol or oxyquinoline sulphate is an artificial chemical 
substance which comes in the form of a yellow powder. It 
is used as an antiseptic for the skin, as a nasal spray, as a 
gargle and for douches in 1-5000 to 1-1000 solutions. 

Alumnol 

(Alumini Naphtholsulphonas) 

This is used in i-1% solutions as a surgical antiseptic, 
as a gargle and for douches. 

Phenoco 

This is a mixture of coal tar creosote and other coal tar 
derivatives in soap solution. It is used as a surgical antisep- 
tic in 1-5% solutions. 

Veroform 

This is a liquid obtained by dissolving formaldehyde gas 
in a solution of soap. It contains 6-20% formaldehyde gas 
and is used as a surgical antiseptic. 



588 MATERIA MEDICA 



ANTISEPTICS USED AS DRESSINGS FOR WOUNDS, 
ULCERS AND SINUSES 

The following antiseptics are the ones most frequently 
used as wet dressings or to irrigate wounds, ulcers and 

sinuses. 

Corrosive Sublimate In 1-10,000 to 1-1000 solutions 

(Bichloride of Mercury) 

Aluminium Acetate Solution 
(Burrow's Solution) 

This is used in 1 to 2% solutions and is especially valuable 
when it is desired to harden the tissues. 

Boro Salicyl Solution 

(Thiersch Solution) (See page 499.) 

OXIDIZING DISINFECTANTS 

The following drugs act as disinfectants by liberating 
oxygen when they come in contact with organic matter. 

HYDROGEN PEROXIDE 

Hydrogen peroxide or hydrogen dioxide is a liquid which 
is a chemical compound of equal parts of hydrogen and 
oxygen. A 3% solution of hydrogen peroxide is used in 
medicine. 

ACTION 

Local action: Hydrogen peroxide solution is decomposed 
when it comes in contact with organic matter, such as pus 
or blood. It then yields bubbles of oxygen. The oxygen 
then destroys the bacteria with which it comes in contact 
and disinfects the tissues. At the same time it helps to 
loosen the membranes and pieces of dead tissues (sloughs). 
The effect of the peroxide wears off very rapidly. The more 
pus or dead tissue there is in the wound, the more oxygen 
is liberated. 



ANTISEPTICS AND LOCAL REMEDIES 589 

It is used principally to irrigate wounds or sinuses con- 
taining pus. It is also used in infections in the mouth and 
throat and other mucous membrane lined cavities. 

Hydrogen peroxide, together with sodium bicarbonate 
is used to bleach the hair. 



Preparations 

Hydrogen Dioxide 
(Aqua Hydrogeni Dioxidi) 

This contains about 3% of hydrogen peroxide and forms 
about ten volumes of oxygen for every volume of the per- 
oxide used. 

New and Non-official Preparations 

The following drugs are compounds of hydrogen peroxide 
made by replacing the hydrogen by a metal. They act as 
disinfectants and antiseptics like hydrogen peroxide; by 
liberating oxygen. Their effect is said to be more lasting, 
however, since the oxygen is given off very slowly. They 
are often used internally as intestinal antiseptics. 

Calcium Peroxide 0.06-0.3 gm. grs. i-v 

(Calcii Peroxidatum) 

Magnesium Peroxide 0.25-0.5 gm. grs. iv-viii 

(Magnesii Peroxidatum) 

Sodium Peroxide 
(Sodii Peroxidatum) 

This is only used externally in the form of a paste or soap 
in skin diseases like acne. 

Oxone : This is a preparation of fused sodium peroxide. 

Strontium Peroxide 
(Strontium Peroxidatum) 

Zinc Peroxide 
(Zincum Peroxidatum) 

These are used externally in the form of gauze, as a 
dusting powder or a 10% ointment. Peroxide zinc soap 
is a soap containing 10% of zinc peroxide. 



590 MATERIA MEDICA 

Acetozone 1 /e . . t\- -j \ 

Ait. r (Succinic Dioxide) 

Alphozone J 

These are artificial chemical substances which act like 
peroxide. They are used in 1-3000 to 1-1000 solutions on 
wounds, for instruments and for douches. 



POTASSIUM PERMANGANATE 

Potassium permanganate is a salt of manganese. 

ACTION 

When potassium permanganate comes in contact with 
organic substances, such as the albumins of the tissues, it 
combines with the albumins and liberates oxygen, which 
destroys bacteria; acting as an antiseptic and disinfectant. 
When it has combined with the albumins, it no longer 
liberates oxygen and is therefore not effectual. 

Preparations 

Potassium Permanganate 0.06-0.2 gm. gr. i-iii 

(Potassii Permanganas) 

For the hands and wounds it is used in 1-3% solutions. 
It is also used as a gargle and for douches in 1% solution. 

Zinc Permanganate 
(Zinci Permanganas) 

This acts like potassium permanganate and is principally 
used as an injection in gonorrhoea. 

Other oxidizing antiseptics are: 

Sodium Perborate 
(Sodii Perboras) 

This is the sodium salt of perboric acid. It contains 9% 
of oxygen and is used as an antiseptic for wounds and ulcers 
and as a dusting powder. 

Perogen Bath Salts or Oxygen Bath Salts is a compound 
containing 10% of sodium perborate. 



ANTISEPTICS AND LOCAL REMEDIES 591 



IODOFORM 

Iodoform is a yellow crystalline powder which has a very 
characteristic odor and a sweet taste. It is a compound of 
methane (marsh gas) with iodine and contains about 97% 
of iodine. 

ACTION 

Local action: Applied to the skin, to wounds or mucous 
membranes, iodoform acts as a mild antiseptic and disinfec- 
tant. It absorbs the fluids from the wound and in this way 
it prevents the growth of bacteria. Iodoform is very sooth- 
ing to the skin or mucous membranes. 

Poisonous Effects 

Iodoform in often absorbed into the blood from wounds or 
sinuses, especially when the surface of the wound is very 
extensive. This is more apt to occur in adults or susceptible 
individuals. It produces the following characteristic poison- 
ous symptoms. 

1. In mild cases there may be only a rise of temperature; 
104° to 105° F. Headache, dizziness, very rapid pulse and 
loss of appetite, also occasionally occur. 

In severe cases the following symptoms may also occur : 

2. The patient feels depressed, downhearted, even mel- 
ancholy. 

3. Hallucinations (ideas of being persecuted and attempts 
at suicide). 

4. Delirium, even mania. 

5. Collapse, which may cause death. 

The symptoms may last for several hours or days. Oc- 
casionally there is no excitement, the patient goes into stupor 
and dies of collapse. 

Preparations 

Iodoform 0.03-0.2 gm. grs. f-iii 

(Iodoformum) 

This is used principally externally in wounds and sinuses 
in the form of Iodoform gauze. 



592 MATERIA MEDICA 

Iodoform gauze is made by soaking sterile gauze in a solu- 
tion containing 5-10% of Iodoform, 20-15% of glycerine 
and adding alcohol up to 100 c.c. 

Iodoform Ointment 
(Unguentum Iodoformi) 

This contains 10% of iodoform. 

New and Non-official Derivatives 

Iodol 0.25 gm. grs. iv 

(Iodolum) 

This is an artificial chemical substance formed by the 
action of iodine on mineral oils. It contains 85% of iodine, 
but its odor is not as unpleasant as that of iodoform. 

Iodoformogen 
(Iodoformalbumen) 

This is an odorless compound of iodoform and albumin. 
It is used principally as a dusting powder. 

Aristol 

(Thymolis Iodidum) 

This is a yellowish brown powder which is used like iodo- 
form but it has a more pleasant odor. 

Europhen: This is an artificial chemical substance which 
is used as a dusting powder. It is occasionally given inter- 
nally in doses of 0.2-0.3 gm. (grs. iii-v). 

Vioform: This is an artificial chemical substance, con- 
taining iodine, which acts like iodoform. It is more efficient 
than iodoform and does not cause poisonous symptoms. 

Antiseptol 

Antiseptin 

Sozoiodol 

Sozal 

Sulphaminol 

Thiophene 

BISMUTH PREPARATIONS 

A number of preparations of bismuth have been made, 
consisting of bismuth combined with a carbolic acid deriva- 



These are other unofficial derivatives of iodoform. 



ANTISEPTICS AND LOCAL REMEDIES 593 

tive. The bismuth itself is only slightly disinfectant. This 
action being due to its insolubility, so that the fluid from the 
wounds is absorbed and the bacilli are unable to grow. 
Most of the antiseptic action, however, is due to the phenol 
derivative. 

Preparations 

Bismuth Subgallate (Dermatol) 
(Bismuthi Subgallas) 

This is used as an antiseptic dusting powder on wounds. 
Gauze soaked in bismuth is now frequently used instead of 
iodoform gauze. Bismuth paste is frequently injected into 
deep wounds (sinuses) to make them heal more readily. 

Bismuth Subcarbolate 
(Bismuthi Subcarbolas) 

New and Non-official Preparations 

Airol 

(Bismuth Iodosubgallate) 

This combines the action of iodoform and bismuth and is 
odorless. 



Thioform 

(Bismuthi Dithio Salicylate) 

Xeroform 

(Bismuthi Tribromphenolas) 

Bismuth Phenolate 

Bismuth Cresolate 

Bismuth Sulphocarbolate 

Dermol 

(Bismuth Chrysophenate) 

Eudoxin 



These are used as antiseptic and 
astringent dusting powders for 
wounds and various skin diseases. 
They are also given as intestinal 
antiseptics in doses of 1.0-4.0 c.c. 
(grs. xv-3i). 



PICRIC ACID 

Picric acid is a yellow crystalline powder. 

ACTION 

When applied locally it checks the growth of bacteria 
(antiseptic) and contracts the skin and mucous membranes. 



594 MATERIA MEDICA 

It is used as wet dressings on burns and other wounds and 
occasionally as douches. It is often applied in the form of 
an ointment. 

In large doses it is absorbed from the skin and causes the 
following poisonous symptoms: A yellow color of the skin, 
and mucous membranes, and of the urine, and occasionally 
convulsions and collapse. 

ANTISEPTICS USED FOR MUCOUS MEMBRANE LINED 

CAVITIES 

BORIC ACID AND BORAX 

Boric acid or boracic acid is a weak acid formed by the 
combination of the element boron with hydrogen. 

ACTION 

Local action: Applied to the skin or mucous membranes, 
boric acid checks the growth of bacteria, but does not de- 
stroy them (antiseptic). It is also soothing to the skin. 

Boric acid is rarely used internally, but when it is given, it 
increases the flow of urine. 

Poisonous Effects 

The irrigation of abscess cavities, the pleural cavity and 
other cavities of the body with boric acid, has occasionally 
caused the following symptoms: 

1. Abdominal pain. 

2. Nausea, vomiting and diarrhoea. 

3. Headache and dimness of vision. 

4. Collapse; rapid, thready pulse, slow shallow breathing 
and subnormal temperature. 

These symptoms may cause death. 

Continued use of boric acid even in the form of wet 
dressings, causes scaly skin eruptions such as eczema, and 
baldness. 

Uses 
Boric acid is used as an antiseptic for mucous membranes 



ANTISEPTICS AND LOCAL REMEDIES 595 

such as the conjunctiva. It is especially valuable as a mouth 
wash and gargle because of its mild action, and it is the 
principal ingredient of most mouth washes. It is also used 
to irrigate wounds and abscess cavities. 

Preparations 

Boric Acid (Boracic Acid) 0.3-1.0 gm. grs. v-xv 

(Acidum Boricum) 

For external use 2-5% solutions are employed. 

Sodium Borate (Borax) 0.3-1.0 gm. grs. v-xv 

(Sodii Boras) 

Boroglycerine 
(Glyceritum Boroglycerini) 

This is a compound formed by heating boric acid in glyc- 
erine. It contains 31% of boric acid. 

Liquor Antisepticus 

This is a compound containing 2% of boric acid together 
with benzoic acid, thymol, eucalyptol, oil of peppermint 
and oil of thyme. It is marketed under the name of Glyco 
Thymoline. 

DobelFs Solution 

This contains 1|% of sodium borate, carbolic acid, 
sodium bicarbonate, glycerine and water. It is used as an 
alkaline gargle and as an antiseptic nasal douche. 

Boric Acid Ointment 
(Unguentum Acidi Borici) 

This contains 10% of boric acid. 

Listerine (Not official) 

This is a compound containing 2|% of boric acid, to- 
gether with benzoic acid, thymol, eucalyptol, oil of winter- 
green, oil of peppermint, tincture of baptista, alcohol and 
water. 

For the nose and larynx the following preparations are 
principally used : 



596 MATERIA MEDICA 

Boric Acid (in 2-5% solutions) 

DobelTs Solution 

Eucalyptol 

Benzoin 

INTESTINAL ANTISEPTICS 

NAPHTHALENE 

Naphthalene is a substance obtained from coal tar. 

ACTION 

Applied to the skin or mucous membranes it checks the 
growth of bacteria. When given internally, it checks the 
growth of bacteria in the intestines thereby relieving the for- 
mation of gas. A little of the naphthalene is absorbed into 
the blood, and this is eliminated by the lungs. Here it in- 
creases the secretion of the mucous membrane and also 
acts as an antiseptic. Most of it is excreted by the foeces. 

Large doses cause symptoms like that of carbolic acid 
poisoning. 

Naphthalene is used principally as an intestinal antiseptic 
for tape worms; to increase coughing, and as an antiseptic 
for abscesses in the lungs. 

Preparations 

Naphthalene 0.06-0.3 gm. grs. i-v 

(Naphthalenum) 

Betanaphthol 0.2-0.6 gm. grs. iii-x 

(Naphthol) 

Betanaphthol Benzoate (Not official) 0.2-0.5 gm. grs. iii-viii 
(Naphtholis Benzoas) 

This forms benzoic acid and naphthol in the intestines. 

Betol (Not official) 0.3-0.5 gm. grs. v-viii 

(Naphtholis Salicylas) 

This forms salol and naphthol in the intestines. 

All these preparations should be given in keratin coated 
pills so that they will be dissolved only by the alkaline 
juices in the intestines. 



ANTISEPTICS AND LOCAL REMEDIES 597 



THYMOL 

Thymol is a stearoptene resembling carbolic acid chem- 
ically, which is obtained by evaporating the oil of thyme. 
This is a volatile oil obtained from Thymus vulgaris and 
other similar herbs which are found in most countries. 

ACTION 

Thymol produces the following effects: 

1. It acts as an antiseptic on the skin and mucous mem- 
branes. 

2. It checks the growth of bacteria in the intestines; 
thereby lessening fermentation. 

3. It is said to lower temperature, and it produces per- 
spiration. 

Large doses occasionally cause ringing in the ears, deafness, 
diarrhoea and delirium. 

It is used principally as an antiseptic gargle and mouth 
wash, as an intestinal antiseptic, and as a remedy for hook 
worm. 
Thymol 0.03-2.0 gm. grs. J-xxx 

EUCALYPTOL 

Eucalyptol is a substance obtained from the oil of eucalyp- 
tus and other volatile oils. The oil of eucalyptus is the active 
volatile oil of the Eucalyptus globulus, or blue gum tree, 
which grows in southern countries and has the peculiar qual- 
ity of absorbing moisture from the soil. It is therefore used 
to drain swamps, and in this way it helps to purify a malarial 
district; since mosquitoes develop in swampy regions. 

ACTION 

Eucalyptol produces the following effects: 

1. Locally; it acts as an antiseptic and reddens the skin 
and mucous membranes. 

2. Internally; it checks the growth of bacteria in the intes- 
tines and increases the secretions. 

3. After absorption it increases all the secretions, such 



598 MATERIA MEDICA 

as the perspiration and bronchial mucous. It also makes 
the pulse stronger and faster. 

4. It is used in the treatment of malaria, as an intestinal 
antiseptic, and is inhaled in lung abscesses and fetid bron- 
chitis. 

Preparations 

Eucalyptol 0.3-1.0 c.c. m. v-xv 

Oil of Eucalyptus 0.3-1.0 c.c. m. v-xv 

Apinol 0.3-1.0 c.c. m. v-xv 

This is a substance obtained by the destructive distillation 
of pine wood. It is used principally as an intestinal antisep- 
tic and to loosen the mucous in the bronchi. 

CHARCOAL (Carbo ligni) 

Charcoal is obtained by burning wood or bones. It 
readily absorbs gases, and in this way it removes foul odors 
(deodorant). 

It is given in doses of 2.0^4.0 gms (5|—i) in wine, or be- 
tween two slices of bread and butter. 

ANTISEPTICS ACTING AFTER ABSORPTION 

The following group of drugs act as antiseptics on the 
various organs by which they are excreted. 

ANTISEPTICS ACTING ON THE LUNGS 

CREOSOTE 

Creosote is a substance made by distilling wood tar. It 
consists of a number of compounds of hydrogen and carbon, 
many of which are related chemically to carbolic acid. 

ACTION 

The action of creosote is similar to that of carbolic acid; 
it is not as strong an antiseptic as carbolic acid, but it is 
more poisonous. It produces the following effects. 

1. Locally it relieves pain and acts as an antiseptic. 

2. When given internally it acts as an intestinal antiseptic. 



ANTISEPTICS AND LOCAL REMEDIES 599 

3. It is absorbed from the intestines and it then lowers 
temperature, increases the perspiration and all the secretions, 
especially the bronchial secretions. 

4. It is eliminated by the lungs and urine. It acts as an 
antiseptic in both of these organs. 

Creosote is used principally as an antiseptic in pulmonary 
tuberculosis or lung abscesses; to destroy the bacteria in the 
lungs. It is often given by inhalation. 

Preparations 

Creosote 0.06-0.3 c.c. m. i-v 

(Creosotum) 

Creosote Water 2.0-8.0 c.c. 3f-ii 

(Aqua Creosoti) 
This contains 1% of creosote. 

Creosote Carbonate (not official) 0.3-2.0 gms. grs. v-xxx 
(Creosotal) 

GUIACOL 

Guiacol is a colorless volatile liquid made by the distilla- 
tion of beechwood tar creosote. 

The action of guiacol is like that of creosote, with the 
following differences: 

1. It may be absorbed from the skin and then reduce 
temperature. 

2. Large doses often turn the urine a dark brown color and 
cause diarrhoea. 

It is used for the same conditions as creosote. 

Guiacol 0.5 c.c. m. viii 

Guiacol Carbonate (Duotal) 0.3-1.3 gm. grs. v-xx 
(Guiacol Carbonas) 

New and Non-Official Preparations 

Guiacol Salol 1.0 gm. grs. xv 

(Guiacolis Salicylas) 

Guiamar 0.3-1.3 gms. grs. v-xx 

Guiajasanol 1.0-3.0 gms. grs. xv-xlv 



600 MATERIA MEDICA 

Monotal 2.0-4.0 gms. 5i~i 

(Guiacolis Methylgly colas) 

Guiacol Cinnamate 1.0 gm. grs. xv 

(Styracol) 

This combines the antiseptic properties of guiacol and 
cinnamic acid. 



GENITO-URINARY ANTISEPTICS 

The drugs in the following group are used principally as 
urinary antiseptics. They are eliminated by the urine, de- 
stroying the bacteria in the kidneys, ureters and bladder, in 
their passage through these organs. 

BENZOIC ACID AND ITS SALTS 

Benzoic acid or flowers of benzoin is an organic acid ob- 
tained from benzoin; the hardened sap of the Styrax ben- 
zoini, a Peruvian tree. Benzoic acid is one of the oldest 
antiseptics known. It was contained, together with cinnamic 
acid, a closely related substance, in the balsams which the 
Egyptians used to embalm their dead. The excellent preser- 
vation of their mummies even at the present time attests to 
the efficiency of these substances. 

ACTION 

Local action: Applied to the skin or mucous membranes 
benzoic acid acts as an antiseptic. It also increases the secre- 
tion of all mucous membranes. 

Internal action: When taken internally, benzoic acid or 
its compounds check the growth of bacteria in the intes- 
tines. It is absorbed from the stomach and intestines, and 
it then makes the pulse faster, and increases the secretions; 
especially the sweat and bronchial secretions. 

It is eliminated by the urine; which it slightly increases. 
It acts as an antiseptic along the urinary tract. It is ex- 
creted as hippuric acid, which makes the urine more acid in 
reaction. 



ANTISEPTICS AND LOCAL REMEDIES 601 

Preparations 

Benzoic Acid 0.3-1.0 gm. grs. v-xv 

(Acidum Benzoicum) 

Sodium Benzoate 0.3-2.0 gms. grs. v-xxx 

(Sodii Benzoas) 

This is used principally as a urinary antiseptic. It is 
also frequently used as a preservative for canned foods. 

Ammonium Benzoate 0.3-2.0 gms. grs. v-xxx 

(Ammonii Benzoas) 

Lithium Benzoate 0.3-2.0 gms. grs. v-xxx 

(Lithii Benzoas) 

Benzoin 

This is the thickened sap obtained from the Styrax 
benzoini, a Peruvian tree. Its compounds are used prin- 
cipally to increase the secretions in the lungs, and in inflam- 
mations of the nose and bronchi. 

Tincture of Benzoin 2.0-4.0 c.c. 3§-i 

(Tinctura Benzoini) 

Compound Tincture of Benzoin 2.0-8.0 c.c. 5j-ii 
(Tinctura Benzoini Composita) 

This contains benzoin, styrax, aloes and balsam of Tolu. 
It was formerly known as Balsamum traumaticum. It is 
contained in a number of old remedies, such as Friar's bal- 
sam, Turlington's balsam, Jesuits drops, etc. It is frequently 
given by inhalation for inflammations of the larynx and 
bronchi. Benzoin is also contained in the balsam of Peru 
and balsam of Tolu. 

Cinnamic acid is a substance closely related chemically 
to benzoic acid and produces the same effects. 

Styrax or storax is the sap obtained from the inner bark 
of the Liquidamber orientalis, an Asiatic tree. It contains 
cinnamic acid. 

DRUGS CONTAINING VOLATILE OILS ACTING AS 
GENITO-URINARY ANTISEPTICS 

The following drugs act as antiseptics on the mucous 



602 MATERIA MEDICA 

membranes of the genito-urinary tract, by virtue of the 
volatile oils which they contain. They all have practically 
the same action. 

ACTION 

When applied locally, they redden the skin or mucous 
membranes. 

When taken internally, they check the formation, and aid 
in the expulsion of gas from the intestines, and act as ca- 
thartics. They are absorbed from the stomach and intestines, 
but produce no effects, except a slight reduction of tem- 
perature. 

They are eliminated by the urine and expired air, acting as 
antiseptics on the mucous membranes of the organs through 
which they are excreted. They slightly increase the flow 
of urine. 

The drugs of this group are used principally as antiseptics 
for gonorrhoea, cystitis, etc. 

Large doses often cause nausea and vomiting and various 
rashes, such as urticaria. 

Preparations 

COPAIBA: An oleoresin obtained from the sap of the 
Copaiba Langsdorfii, a tree growing in Brazil and other South 
American countries. 

Copaiba 0.6-2.0 c.c. m. x-xxx 

Oil of Copaiba 0.6-1.0 c.c. m. x-xxx 

(Oleum Copaibae) 

CUBEBS: A powder made from the unripe fruit of the 
Piper Cupeba, an East Indian Plant. 

Fluidextract of Cubebs 0.6-2.0 c.c. m. x-xxx 

(Fluidextractum Cubebae) 

Oleoresin of Cubebs 0.6-1.0 c.c. m. x-xv 

(Oleoresinae Cubebae) 

Oil of Cubebs 0.6-1.0 c.c. m. x-xv 

(Oleum Cubebae) 



ANTISEPTICS AND LOCAL REMEDIES 603 

SANDAL WOOD OIL: A volatile oil distilled from the 
wood of the Santalum album, an American tree. 

Oil of Sandal Wood 0.6-1.0 c.c. m. x-xv 

(Oleum Santali) 

OIL OF ERYGERON: This is a volatile oil obtained by 
distilling Erygeron canadense, or Canada fleabane, an Amer- 
ican herb. It is used as a geni to-urinary antiseptic, to check 
bleeding and to increase menstruation. 

Oil of Erygeron 0.3-2.0 m. v-xxx 

(Oleum Erygerontis) 

BUCHU: This is a substance obtained from the leaves of 
the Barosma betulina and Barosma crenulata, two South Amer- 
ican plants. Its active principle is a stearoptene, Diosphenol, 
which is excreted by the urine and acts as an antiseptic 
along the genito-urinary tract. It is used in the treatment 
of gonorrhoea. 

Fluidextract of Buchu 2.0-4.0 c.c. 5ss-i 

(Fluidextractum Buchu) 

MATICO : This is the dried tops of Piper angustifoliorum, a 
South American plant. It is used as a genito-urinary anti- 
septic. 

Fluidextract of Matico 1.0-3.0 c.c. m. xv-xlv 

(Fluidextractum Matico) 

HEXAMETHYLENAMINE (UROTROPINE) 

Hexamethylenamine or Urotropine is an artificial chemical 
substance which is used principally as a urinary antiseptic. 

ACTION 

Urotropine liberates formaldehyde gas in the urine. This 
disinfects the urine and the mucous membranes of the genito- 
urinary tract with which it comes in contact. 

Large doses occasionally cause burning pain in the stom- 
ach, pain on urination, and the urine occasionally contains 
blood. 



604 MATERIA MEDICA 

Urotropine has also been used in various septic conditions 
because of the formaldehyde gas which it liberates in the 
blood. It has frequently been injected into the spinal canal 
for meningitis. 

Preparations 

Hexamethylenamine 0.2-0.6 gm. grs. iii-x 

(Urotropine) 

This preparation is also on the market under various 
names, such as Formin, Aminoform, etc. Other unofficial 
compounds of Hexamethylenamine are: 

Hexal 1.0 gm. gr. xv 

(Hexamethylenamine Salicylsulphonic Acid) 

Helmitol 0.6-1.0 gm. grs. x-xv 

(Hexamethylenaminae Methylencitras) 

Saliformin 0.3-2.0 gms. grs. v-xxx 

(Hexamethylenaminae Salicylas) 

METHYLENE BLUE (METHYLTHIONINAE HYDRO- 
CHLORIDUM) 

Methylene blue is a chemical substance which forms a 
deep blue solution in water. It is used principally as a 
urinary antiseptic in gonorrhoea, and as a specific for 
malaria. It stains the urine a blue or dark green color. It 
is given in capsules, in doses of 0.1-0.5 gm. (grs. ii-viii). 



LOCAL REMEDIES 

The following remedies are used principally for the local 
effects which they produce. They are divided into two 
distinct groups : 

(a) Drugs which irritate the skin or other tissues. 

(b) Drugs which sooth or protect the tissues. 

DRUGS WHICH IRRITATE THE SKIN OR OTHER TISSUES 
POTASSIUM CHLORATE 

Potassium chlorate is a white crystalline powder having a 
cool salty taste. The effects it produces are due to the 
chlorate ion of the salt. 

ACTION 

Applied to the skin or mucous membranes, potassium 
chlorate causes redness. It relieves inflammation of ulcer- 
ated surfaces or mucous membranes. It is frequently used 
as a gargle for sore throat and for ulcerations of the mouth 
following mercury poisoning. It increases the flow of urine, 
but it is seldom given for this effect, because of its poisonous 
action. 

POISONOUS EFFECTS 
Acute Potassium Chlorate Poisoning 

This condition usually results when a Potassium Chlorate 
gargle is swallowed by mistake. The symptoms it produces 
are due to the formation of methaemoglobin in the blood. 
The blood is then unable to carry oxygen to the issues. At 
the same time the potassium chlorate injures the kidneys, 
producing symptoms of nephritis. If most of the haemo- 
globin in the blood has been changed to methaemoglobin, 
the acute form of poisoning results. If there is still some 
haemoglobin unchanged, the subacute form occurs. 

605 



606 MATERIA MEDICA 

Symptoms 

1. Excessive secretion of saliva and of the mucous mem- 
branes. 

2. Violent vomiting and diarrhoea. 

3. Shortness of breath and cyanosis. 

4. Rapid weak irregular pulse (due to the potassium). 

5. Dizziness, muscular weakness, coma and death. 

Subacute Poisoning 

This condition results from smaller doses and produces 
the following symptoms: 

1. Profuse vomiting and diarrhoea (the vomited matter 
contains bile and occasionally blood). 

2. Scanty urine; which may contain haemoglobin and 
methaemoglobin. 

3. Jaundice, and small haemorrhages into the skin. 

4. Abdominal pain, delirium, convulsions and coma. 
Death has occurred from heart failure in a few days, or 

later from uraemic symptoms. 

Treatment 

Wash out the stomach, give heart stimulants. The condi- 
tion is best relieved by removing a quantity of blood from 
a vein (and thereby a quantity of the methaemoglobin) and 
then injecting normal salt solution into the vein. 

Preparations 
Potassium Chlorate 0.3-1.0 gm. grs. v-xv 

(Potassii Chloras) 

As a gargle it is used in 4-6% solutions. 

Troches of Potassium Chlorate. Each containing 0.3 gm. (grs. v) 
(Trochisci Potassii Chloratis) 

Sodium Chlorate 0.3-1.0 gm. grs. v-xv 

This has the same action as potassium chlorate. 

MYRRH (MYRRHA) 
Myrrh is a gum resin obtained from the Commiphera 






ANTISEPTICS AND LOCAL REMEDIES 607 

Myrrha, an American tree. Its active principle is a volatile 
oil. 

It reddens the skin and mucous membranes and is slightly 
disinfectant. It increases the secretions and is said to in- 
crease menstruation. 

It is used principally as an irritant in inflammations of 
the gums as in mercury poisoning, and as a cathartic. 

Tincture of Myrrh 2.0-4.0 c.c. 3H 

(Tinctura Myrrhae) 

CHRYSAROBIN 

Chrysarobin is a substance obtained from cavities in the 
Andira araroba, a tree growing in India and Brazil. Its active 
principle is Chrysophanic acid. 

When applied to the skin, it causes redness, pain and even 
swelling. Large doses, when absorbed from the skin or when 
taken internally, cause nausea, vomiting, diarrhoea and 
scanty, bloody urine. 

It is used principally in 4% ointments for the treatment 
of various skin diseases. 

Araroba or Goa Powder, is the crude powder from which 
Chrysarobin is made. 

SCARLET R (not official) 

This is a chemical dye which is said to increase the forma- 
tion of granulation tissue (young scar tissue). It is used for 
this purpose in 4-8% ointments in the treatment of wounds 
and ulcers. 

COUNTER IRRITANTS 

The following group of drugs are applied principally to 
the skin. They produce two kinds of effects; local and re- 
mote. 

Local Effects 

The local effects are the effects produced at the site of 
application, and depend upon the length of time the drug 



r 



608 



MATERIA MEDICA 




is applied, or upon the strength of the preparation used. 
Thus, a weak preparation applied for a short time, produces 
only redness; if it is kept on for a longer time, or if a stronger 
preparation is used, a blister will form. A still stronger 
action consists in the formation of pustules, or even in the 
destruction of the skin (escharotic action). 

Remote Effects 

The remote effects produced by this group of drugs are of 
two kinds, circulatory and reflex. 

The circulatory effects are due to the reddening of the 
skin. This brings more blood to the surface of the skin from 
the underlying or deeper tissues and organs. These tissues 
and organs then become anaemic. In this way, by with- 
drawing their excessive blood, it relieves the inflammation 
or congestion of the deeper organs. For example, the applica- 
tion of a mustard plaster to the chest will often relieve 
bronchitis (inflammation of the bronchi) by drawing the 
blood from the inflamed bronchi to the surface of the skin. 

The reflex effects are due to the action on the nerve areas 
in the skin which are related to the deeper organs. For 
example, the application of a flaxseed poultice to the ensi- 
form cartilage often relieves various pains in the stomach. 
The other reflex effects of such applications are a slight in- 
crease in the blood pressure and momentary deeper breath- 
ing; but these effects are very slight. 

The counter-irritants are best classified according to the 
effects they produce in the usual strength in which they are 
commonly used, though the same effects can be obtained 
from all of them. 

1. Rubefacients: Drugs that produce redness of the skin. 

2. Vesicants : Drugs that produce blisters on the skin. 

3. Pustulants: Drugs that produce pustules on the skin. , 

4. Escharotics: Drugs that destroy the skin. 

RUBEFACIENTS 

The Rubefacients are used principally to redden the skin, 
to relieve congestion of the underlying tissues and to relieve 
pain in remote organs. 



ANTISEPTICS AND LOCAL REMEDIES 609 

Mustard: The powdered dried ripe seeds of Brassica nigra 
and Brassica alba. It is used in the form of a mustard 
plaster, or as a mustard paste made up with 4 to 5 parts of 
flour. For preparations and action see page 92. 

Capsicum: Cayenne pepper is used in the form of a 
plaster. For other actions see page 76. 

Oil of Turpentine: This is applied on a piece of flannel 
and is frequently used as a rubefacient. 

Ammonia Liniment: This contains 35% of ammonia water 
in cotton seed oil and alcohol. It is frequently used as 
a rubefacient. Other substances used as rubefacients are: 

Chloroform Liniment 
Camphor Liniment 
Sabine 
Juniper 

VESICANTS 

Vesicants or Epispastics are drugs used to produce blisters. 
In this way they withdraw fluid from the deeper tissues into 
the blister. They are used to produce this effect in joint 
affections, in various inflammations of the internal organs 
and for neuralgic pains. They are apt to weaken the patient, 
and should not therefore be applied on very old patients or 
on infants. 

CANTHARIS (CANTHARIDES) 

Cantharides or Spanish fly is the dried beetle found in 
various temperate climates; especially in Spain and Italy. 
Its active principle is a neutral substance cantharidin. 

ACTION 

Applied to the skin: it causes redness and swelling with 
the formation of a blister. Internally, in small doses it in- 
creases the flow of urine. It is said to increase sexual desire. 

Poisonous Effects 

Absorption of cantharides from the skin, or when taken 



610 MATERIA MEDICA 

internally in large doses, produces the following symptoms; 
which are due to the injury of the kidneys and alimentary 
tract. 

1. Profuse vomiting and diarrhoea. 

2. Painful, scanty urination, with scanty urine, which 
often contains blood. 

3. Delirium, convulsions and collapse. 

If it is taken in solution it causes blisters in the mouth and 
oesophagus, which often prevent swallowing. 

The symptoms are best relieved by washing out the stom- 
ach, the administration of opium for the pain, and giving 
demulcent drinks. 

Preparations 

Cerate of Cantharides 
(Ceratum Cantharidis) 

Cantharides Collodion 
(Collodium Cantharidatum) 

Tincture of Cantharides 0.12-0.3 c.c. m. ii-v 

(Tinctura Cantharidis) 

Cantharides is frequently applied in the form of a plaster : 
a small piece of the plaster, the size of a dime is applied over 
the affected area. 

Before applying cantharides, the skin should be shaved, 
cleansed with soap and water, alcohol and ether. The plaster 
is then applied and left on for about 4 to 8 hours, depending 
upon the effect desired. 

Cantharis Vittata: This is the dried potato fly which con- 
tains cantharidin. It is occasionally used as a substitute 
for cantharides. 

Strong Ammonia Water 
(Aqua Ammoniae Fortior) 

This is frequently used to produce blisters. 

PUSTULANTS 

Pustulants are drugs which produce very violent action on 
the skin so that a crop of pustules forms. They are not used 



ANTISEPTICS AND LOCAL REMEDIES 611 

very frequently. The remedies which were formerly used 
for this purpose were Croton Oil and Antimony. 

ESCHAROTICS 

Escharotics or caustics are drugs which are applied locally 
to destroy tissues. The destroyed tissue is called the slough 
or eschar. The drugs of this group are used principally to 
destroy infected tissue such as the bite of an animal, to de- 
stroy warts and to increase the healing of ulcers. The fol- 
lowing substances are used principally for this purpose. 
They have been fully described under their other more im- 
portant actions. 

Alkalies 
Potassium Hydroxide 
Sodium Hydroxide 

Acids 

Nitric Acid 
Glacial Acetic Acid 
Trichloracetic Acid 
Chromic Acid 

This preparation occurs in the form of dark purplish crys- 
tals which take up moisture from the atmosphere (hygro- 
scopic). 

Metals 

Zinc Chloride 

Corrosive Sublimate 

Solution of Mercurous Nitrate 

Silver Nitrate 

Copper Sulphate 

Alum 

Bromine 

DRUGS WHICH SOOTHE OR PROTECT THE TISSUES 

The drugs in this group are divided into three classes. 
1. Demulcents: Drugs which soothe the skin. 



612 MATERIA MEDICA 

2. Emollients: Drugs which soften the tissues. 

3. Protectives : Drugs which protect the skin. 



DEMULCENTS 

Demulcents are bland substances which are used to soothe 
inflamed tissues. They are also used to suspend substances 
which cannot otherwise be dissolved, in mixtures. 

ACTION 

The demulcents are all sticky substances which swell up 
into jelly like masses when they are dissolved in water. 
They prevent the tissues from coming in contact with in- 
jurious fluid or gaseous particles, and in this way they relieve 
the pain of inflammations and protect the tissues from in- 
jurious substances. 

Preparations 

ACACIA or GUM ARABIC: This is the gummy sap ob- 
tained from the Acacia Senegal, an African tree. It contains 
calcium combined with Arabic acid. It is used in making 
emulsions of various drugs and pills. 

Mucilage of Acacia 16.0. c.c. 5iv 

(Mucilago Acaciae) 

This contains one part of acacia to two parts of water. 

Syrup of Acacia 
(Syrupus Acaciae) 

TRAGACANTH: This is a gummy sap obtained from the 
Astragalus gummifer, an Oriental tree. It is principally 
used to suspend heavy powders in water and in the making 
of pills. 

Mucilage of Tragacanth 16.0 c.c. giv 

(Mucilago Tragacanthae) 

ULMUS or ELM : This is the inner bark of the Ulmus f ulva 
or slippery elm tree of the United States. When mixed with 



ANTISEPTICS AND LOCAL REMEDIES 613 

water it forms a mucilage-like substance which is very sooth- 
ing to the tissues. It is often used in the form of a poultice. 

Mucilage of Elm 
(Mucilago Ulmi) 

ALTHAEA: This is obtained from the root of Althaea offi- 
cinalis or marshmallow. 

LINUM (flaxseed or linseed). This is the dried ripe seed 
of Linum usitatissimum or the flax plant. 

Flaxseed meal is the ground dried seeds and is used prin- 
cipally as a poultice. The seeds themselves are often given 
in the form of an infusion (flaxseed tea) to relieve bronchitis, 
painful urination and painful defecation. 

SASSAFRAS MEDULLA: This is the pith of Sassafras 
varifoliorum. The mucilage of sassafras is principally used to 
soothe inflammations of the eye, and is occasionally given 
internally. 

GLYCYRRHIZA or LICORICE ROOT: This is the root and 
underground stems of the Glycyrrhiza glabra, an English plant. 
It is used principally to soothe mucous membranes. It has 
a very pleasant taste because of its active glucoside gly- 
cyrrhizin, and it is used for this reason to flavor medicines. 

Extract of Licorice Root 
(Extractum Glycyrrhizae) 

Refined Extract of Licorice Root 
(Extractum Glycyrrhizae Purum) 

Fluidextract of Licorice Root 
(Fluidextractum Glycyrrhizae) 

Compound Licorice Powder 
(Pulvis Glycyrrhizae Compositus) 

This contains senna and is used principally as a cathartic. 

Troches of Licorice and Opium 

(Trochisci Glycyrrhizae et Opii 

Brown's Mixture 15.0-30.0 c.c. 5-J-i 

(Mistura Glycyrrhizae Compositus) 

These two mixtures contain opium and are used principally 
as soothing cough mixtures. 



1.0 gm. 




grs. xv 


1.0 gm. 




grs. xv 


2.0 c.c. 




m. xxx 


2.0-8.0 


gms. 


5J-H 



614 MATERIA MEDICA 

AMYLUM (starch) : This is ordinary starch which is used 
in the form of a dusting powder or is boiled in water and then 
applied as a demulcent. 

Glycerite of Starch (Plasmine) 
(Glyceritum Amyli) 

AMYGDALA DULCIS (Sweet Almonds). This is the seed 
of Prunus amygdala dulcis or the almond tree. It contains a 
fixed oil and a ferment emulsin. When the almonds are 
rubbed together with water, a bland emulsion is formed 
which is very soothing to the tissues. 

Emulsion of Sweet Almonds 120.0 c.c. giv 

(Emulsum Amygdalae) 

Syrup of Sweet Almonds 
(Syrupus Amygdalae) 

This is a mixture of sweet and bitter almonds and contains 
a little prussic acid. 

CHONDRUS (Irish Moss or Carragheen) : This is obtained 
from Chondrus crispus, a seaweed found on the coast of Ire- 
land and Massachusetts. It forms a jelly-like mass when 
dissolved in water because of a starchy substance, carra- 
geenin, which it contains. Various preparations of chondrus 
such as lubrichondrin, are used as lubricants for the passage 
of catheters or other instruments. 

KAOLINUM (Kaolin) : This is a clay-like substance consist- 
ing of Aluminium silicate. It is used principally as a demul- 
cent. 

CATAPLASMA KAOLINI: This is a clay-like poultice con- 
sisting of boric acid, methyl salicylate, glycerine, thymol, oil 
of peppermint, and kaolin. It withdraws fluid from the 
tissues and is very soothing. It is on the market under 
various names; such as Antiphlogistine, Fullers Earth, etc. 

TALCUM: This is magnesium silicate and is used as a 
bland soothing dusting powder. 

LYCOPODIUM : This consists of the spores of Lycopodium 
clavatum or club moss. It is used principally as a soothing 
dusting powder and in the making of pills. 



ANTISEPTICS AND LOCAL REMEDIES 615 

EMOLLIENTS 

Emollients are bland fatty substances used to soften the 
skin and as a medium for applying other drugs to the skin. 

Preparations 

ADEPS (Lard) : This is the prepared internal fat of the 
abdomen of the pig. It is purified by washing, melting and 
straining. 

Benzoinated Lard 
(Adeps Benzoinatus) 

Ointment 
(Uguentum) 

This is a mixture of lard and yellow wax and forms the 
basis of other ointments. 

Sevum Praeparatum (Suet) : This is obtained from the ab- 
dominal fat of the sheep. 

Adeps Lanae Hydrosus (Wool Fat or lanolin): This is the 
purified fat of sheeps , wool. It takes up watery solutions 
easily and is readily absorbed by the skin. 

PETROLATUM (Paraffins) : These are substances which re- 
main when the more volatile constituents of petroleum are 
distilled. They are used principally in ointments to soften 
the skin. Several of the paraffins which do not melt readily 
are used in surgery for cosmetic purposes. Some of the 
more fluid paraffins are used as laxatives. 

Vaseline 
(Petrolatum) 

White Vaseline 
(Petrolatum Album) 

Liquid Vaseline (Albolene) 
(Petrolatum Liquidum) 

Paraffin 
(Paraffinum) 

This melts at a higher temperature and is used in surgery 
for cosmetic purposes. 



616 MATERIA MEDICA 

OLIVE OIL (Oleum Olivae) : This is a fixed oil obtained 
from the olive, the ripe fruit of Olea Europea; a European 
tree. 

OLEUM LINI: The fixed oil of linseed or flaxseed. 

OLEUM THEOBROMATIS (Cocoa Butter) : The fixed oil 
expressed from the roasted cocoa bean Theobroma cacao. 
It is used principally to make suppositories. 

OLEUM GOSSYPI SEMINIS (Cotton Seed Oil) : The fixed 
oil expressed from the seeds of the cotton plant. 

CETACUM (Spermaceti): This is a fatty substance ob- 
tained from the head of the sperm whale. It is used to give 
consistency to many ointments such as cold cream. 

CERA FLAVA: The yellow wax obtained from the honey- 
comb of the bee. 

CERA ALBA: This is white wax made by bleaching the 
yellow wax. 

Both of these substances are used in making ointments, 
cerates and plasters. 

CERATUM : This is a mixture of 3 parts of wax and 7 parts 
of lard. 

GLYCERINUM (GLYCERINE) 

Glycerine is a liquid made by decomposing animal or 
vegetable fats. 

When applied to the skin or to a wounded surface, glycerine 
smarts and is painful for a few minutes, and then it softens 
the skin. It has the property of withdrawing fluid from the 
tissues (hygroscopic). 

It is often given internally or it is injected into the rectum. 
It then produces mild movements of the bowels without any 
colic. 

Glycerite of Starch 
(Glyceritum Amyli) 

Glycerin of Egg Yolk 
(Glyceritum Vitelli) 

There are a number of preparations of various drugs made 
up with glycerine. They are known as glycerites. 



ANTISEPTICS AND LOCAL REMEDIES G17 



PROTECTIVES 

Protectives are substances used to protect the tissues, 
to keep out infectious material, light or air. 

COLLODIUM (Collodion): This is a 4% solution of py- 
roxilin or soluble gun cotton, in alcohol and ether. When 
collodion is applied to the skin, the alcohol and ether evap- 
orate, leaving a colorless transparent contractile film, which 
is strongly adherent to the skin and protects it. 

Collodion 
(Collodium) 

Flexible Collodion 
(Collodium Flexile) 

This contains Canada turpentine and castor oil in addition 
to the other ingredients, and is more pliable. 

Styptic Collodion 
(Collodium Stypticum) 

This contains 20% of tannic acid and is therefore astringent. 

ELASTICA (India Rubber or Caoutchouc) : The dried milky 
juice of a Brazilian tree. It is known as Para rubber. It is 
used in making adhesive plaster, bougies, etc. 

CALCII SULPHAS EXSICCATUS: This is dried gypsum or 
plaster of Paris. When dissolved in water it forms a thick 
gelatinous mass which becomes hard when exposed to the 
air. It is used alone or with bandages soaked in it. 



CHAPTER XXIII 

SERUMS, VACCINES AND ORGANIC SUBSTANCES 

SERUMS 

When a patient suffers from an infectious disease, and 
then recovers, the disease is overcome (the patient is im- 
munized) by the formation in the blood of antibodies (anti- 
dotes) for the cause of that particular infection. The pro- 
duction of such antibodies in the blood of the patient is 
called active immunization. Similarly, when an animal is 
injected with bacteria or their poisonous excretions (toxins) 
in gradually increasing doses, the animal becomes actively 
immune against the injected bacteria or their toxins. The 
serum of that animal can then be injected into patients 
suffering from a similar infection, to overcome the infec- 
tion. The patient then becomes immunized against this 
particular disease. The production of such immunity is 
called passive immunity, since the antibodies have been formed 
by another animal. 

A serum is the serum of an animal that has been immun- 
ized against a particular bacterium or its toxins. Serums 
are of two kinds: Bacteriolytic, and Antitoxic. 

BACTERIOLYTIC SERUMS 

A bacteriolytic serum is the serum of an animal that has 
been immunized against a particular bacterium. The horse 
is the animal commonly used for the manufacture of serums 
since the largest quantity of serum can be obtained from 
this animal. 

Method of Manufacture 

A horse is injected with a small dose of a solution of the 

618 



SERUMS, VACCINES AND ORGANIC SUBSTANCES 619 

particular bacterium against which the serum is desired. 
The horse then becomes ill and has a rise of temperature, 
which disappears in a few days. When the animal is well 
again, the injection is repeated, but with a larger dose; which 
now does not produce such severe symptoms. 

The injections are repeated until the animal can stand 
injections of large doses of the bacteria without any symp- 
toms being produced. The horse is then immune against 
that particular bacterium, and his serum contains antibodies 
(antidotes) against the bacteria with which he was injected. 
The animal is then bled from the Jugular vein, the blood 
is allowed to clot, and the serum is removed under strictly 
aseptic precautions. This serum, when injected into patients 
suffering from an infection produced by the same bacteria, 
neutralizes their poisonous effects; the antibodies of the 
serum combining with the bacteria. 

Preparations 
Antistreptococcus Serum 

This serum is used in the treatment of septicaemia, 
erysipelas, scarlet fever. It is made by immunizing horses 
against Streptococci. 

Polyvalent Antistreptococcus Serum 

This is made by immunizing horses against several dif- 
ferent strains of Streptococci. 

Antistaphylococcus Serum 

This is made by immunizing horses against dead Staphy- 
lococci. It is used in the treatment of sepsis caused by 
Staphylococci. 

Antipneumococcus Serum 

This is the serum obtained by immunizing horses against 
dead and living Pneumococci. It is used in the treatment 
of pneumonia. 
Antigonococcus Serum 

This is the serum of rams immunized against dead and 



620 MATERIA MEDICA 

living Gonococci. It is especially valuable in the treatment 
of gonorrhoeal joints. 

Antidysenteric Serum 

This is the serum of horses immunized against the dys- 
entery bacillus (Shiga bacillus). 

Antimeningococcus Serum 

This is the serum of horses immunized against dead and 
living Meningococci. It is injected in 15-30 c.c. doses into 
the spinal canal, after the same amount of fluid has been 
withdrawn from the canal. 

Antityphoid Serum 

This is the serum of horses injected with dead cultures of 
typhoid bacilli. 

ANTITOXIC SERUMS 

An antitoxic serum is the serum of an animal that has been 
immunized against the poisonous excretions (toxins) of a bac- 
terium, but not against the bodies of the bacteria themselves. 

Antitoxic serums are prepared in the same way as antibac- 
terial serums but the animal is repeatedly injected with a 
filtrate of a bouillon culture of the bacteria, passed through 
a Berkefeld filter. This filtrate contains only the toxins of 
the bacteria, but not their bodies. 

Preparations 
Diphtheria Antitoxin Serum 

This is the serum of a horse that has been immunized 
against the toxin of the diphtheria bacilli. It contains 
antibodies against the diphtheria toxin. When the serum 
is injected into a patient suffering with diphtheria, the anti- 
bodies combine with the diphtheria toxin, thereby neutraliz- 
ing the symptoms of the disease. 

Diphtheria antitoxin is the most efficient serum which 
is used at the present time. The disappearance of the mem- 
brane in the throat, and the clearing up of all the toxic 
symptoms result in one to two days after the injection. 



SERUMS, VACCINES AND ORGANIC SUBSTANCES 621 

It is usually given in doses of 5000 to 10000 units (an 
antitoxic unit is the amount of antitoxin that will immunize 
a guinea pig weighing 250 gms. against 100 times the fatal 
dose of diphtheria toxin). It should be repeated every 12 
hours until all the symptoms disappear. It should always 
be given early in the disease. In the later stages the toxin 
may have already combined with the nerve cells and com- 
plications may then result; but no case is hopeless. 

Diphtheria antitoxin is also given in doses of 500 to 1000 
units to those who are exposed to diphtheria cases to prevent 
them from contracting the disease (immunizing). 

Diphtheria Antitoxin (Concentrated) 
Refined Diphtheria Antitoxin 
(Antidiphtheritic Globulins) 

These are all specially prepared antitoxins from which 
some of the inactive serum albumins have been removed, so 
that smaller quantities of serum may be used to produce the 
same effects. 

Tetanus Antitoxin 

This is the serum of a horse that has been immunized 
against the toxins of the Tetanus bacilli. 

It is given in doses of 3000 to 20000 units every 4 to 8 hours. 
As an immunizing dose about 1500 units are given. 

BACTERIAL VACCINES 

Bacterial vaccines are solutions of dead bacteria in normal 
salt solution. A |% carbolic acid solution is usually added 
as a preservative. 

They are used to immunize patients against infections 
caused by the same kind of organisms as those that are in- 
jected. There are two kinds of vaccines: Autogenous vac- 
cines and stock vaccines. 

Autogenous vaccines are solutions of bacteria, obtained 
from the patient who is being treated. 

Stock vaccines are solutions of bacteria obtained from 
other sources. 



622 MATERIA MEDICA 

The principle upon which the action of vaccines is based, 
is the following: The injection of the dead bacteria into the 
patient, causes the formation, in the serum of the blood, of 
a substance which excites the phagocytic action (destructive 
action) of the white blood corpuscles, so that they take up 
and destroy the bacteria of the blood more readily. 

The substances formed in the serum by the dead bacteria, 
which increase the phagocytic action of the white blood cor- 
puscles, are called opsonins. 

Preparations 
Staphylococcus Vaccine 

This is a solution of dead Staphylococci and is used in the 
treatment of acne, furuncles and other Staphylococcus in- 
fections. 

Streptococcus Vaccine 

This is a solution of dead Streptococci in salt solution. 
It is used in treating Streptococcus infections. 

Typhoid Vaccine 

This is a solution of dead typhoid bacilli in salt solution. 
It is injected into patients to prevent them from contracting 
typhoid fever when they are exposed to that disease (im- 
munizing them against typhoid). 

Gonococcus Vaccine 

This is a solution of dead Gonococci in normal salt solu- 
tion and is used principally in the treatment of gonorrhoea! 
joints. 

Bacillus Coli Vaccine 

This is a solution of dead colon bacilli in normal salt 
solution. 

Pneumococcus Vaccine 

This is a solution of dead Pneumococci in normal salt 
solution. 

Coley's Serum 

This is a mixture of Bacillus prodigiosus and Streptococci, 
which is used in the treatment of sarcoma. 



SERUMS, VACCINES AND ORGANIC SUBSTANCES 623 

Lactic Acid Bacilli 

A number of bacilli which sour milk by the formation 
of lactic acid, have recently been used very extensively in 
medicine. The most important organism of the group is the 
Bacillus bulgaricus. The presence of these harmless bacilli 
in the intestines, and their formation of lactic acid, prevents 
the growth of other harmful bacteria which cause intestinal 
fermentation and putrefaction. Cultures of these bacilli, 
in solid or liquid form are therefore given to lessen intestinal 
fermentation and to relieve various symptoms resulting 
from this condition. Recently, these cultures have been 
used with considerable success in the treatment of diabetes. 

Solid Preparations 
Bulgara Tablets 2 tablets 

A pure culture of Bacillus bulgaricus. 
Lactic Bacillary Tablets 1-2 tablets 

Fluid Preparations 
Massolin 

This is a pure culture of Bacillus bulgaricus of Massol, 
grown in broth to which calcium salts have been added. 
It is often applied to the throat after an attack of diphtheria 
when the bacilli are still present. 

Lactampoule and a number of other preparations. 

There are a number of preparations of milk on the market 
containing bulgaric bacilli such as Fer mil lac, bacillac, zoolak, 
etc. 

OTHER SERUMS 

Old Tuberculin 

This is a solution obtained by filtering a bouillon culture 
of living tubercle bacilli through a Berkefeld filter and 
adding a little glycerine to it as a preservative. It contains 
the toxins of the tubercle bacilli. It is now only used to 
diagnose tuberculosis, either by injection, which causes a 
rise of temperature, or by the application to the skin. 



624 MATERIA MEDICA 

New Tuberculin 

This is made by grinding up tubercle bacilli and mixing 
them with equal parts of water and glycerine. 
Vaccine Virus 

This is the pus obtained from the pustules of calves 
suffering with cow pox. The pus is obtained under sterile 
precautions and a little glycerine is added as a preservative. 
It is used for vaccination against small pox. 

The principle of vaccination depends on the iact that an 
individual who has had an attack of cow pox, becomes 
immune against small pox. Vaccination produces a mild 
attack of cow pox at the site of the application of the virus. 
This makes the patient immune against small pox. 
Antirabic Vaccine 

This is an emulsion of the spinal cords of rabbits who 
have been inoculated with rabies (hydrophobia) poison. 
After the animals have been inoculated, they are killed and 
their spinal cords removed. The cords are dried, ground and 
made into an emulsion in normal salt solution. This emul- 
sion is used in the treatment and prevention of hydrophobia. 
The treatment is begun with the injection of a weak emulsion 
of a cord which has been dried for a long time, and is followed 
by the injection of stronger emulsions (containing cords which 
have been dried for a shorter time.) 
Normal Horse Serum 

This is ordinary serum obtained by coagulating horses' 
blood, and removing the serum. It is injected into patients 
to increase the clotting of the blood. 
Leucocyte Extract 

This is a fluid made by injecting aleuronat (diabetic flour) 
into the chests of rabbits. This forms a thick fluid (exudate) 
which contains a large number of white blood corpuscles. 
It is used in 10.0 c.c. doses in the treatment of pneumonia. 
Nuclein 0.3-0.6 gm. grs. v-x 

This is a compound of phosphorus and proteids which is 
said to increase the number of white blood corpuscles and 
thereby to destroy bacteria. 



ORGANIC REMEDIES 

The following substances are obtained from various organs 
of animals. They are used in the treatment of diseases due 
to deficient secretion of similar organs in the body. 

THYROID EXTRACT 

Thyroid extract is a powder made by grinding up the 
thyroid glands of sheep. Its active principle is a substance 
called iodothyrin. 

ACTION 

The thyroid gland is a ductless gland which secretes a 
substance into the blood. This substance regulates the 
growth and development of the body. Thus, children who 
have a poorly developed thyroid gland, are stunted in their 
growth, they develop pads of fat in the neck and other 
parts of the body, their intelligence is lessened, and they are 
dull and stupid (Cretinism). 

The administration of thyroid extract to such children 
is followed by startling improvement of their intelligence, 
growth and development. 

Old people in whom the thyroid gland has atrophied, so 
that its secretion is very much lessened, often suffer from 
similar symptoms; such as dullness of mind and drowsiness 
(myxoedema) . 

These symptoms are relieved by the administration of 
thyroid extract. 

Poisonous Effects 

" Hyperthyroidism " 

When the thyroid gland secretes more substances in the 
blood than is necessary, the following symptoms are pro- 
duced: These symptoms frequently occur from certain en- 
largements of the thyroid gland (Exophthalmic goitre or 
Graves' disease). 

625 



626 MATERIA MEDICA 

1. Rapid loss of weight. 

2. Rapid, thready pulse. 

3. Nervousness. 

4. Bulging eyeballs (exophthalmos). 

5. Diarrhoea. 

Thyroid extract is frequently taken to reduce weight in 
obesity. It is a dangerous remedy, as its continued use 
often produces the symptoms of hyperthyroidism. 

Thyroid Extract 0.2-0.6 gm. grs. iii-x 

(Glandulae Thyroidae Siccae) 

Antithyroidin Moebius 0.5-1.0 c.c. m. viii-xv 

This is the serum of goats in whom the thyroid glands 
have been removed about six weeks before the serum is re- 
moved. It is used in the treatment of exophthalmic goitre 
(excessive thyroid secretion). 

Other Organic Substances 
Ovarian Extract 0.06-0.2 gm. grs. i-iii 

This is a powder made from the fresh ovaries of pigs. It 
is used to relieve the symptoms of the artificial menopause, 
which follow the complete removal of both ovaries: such as 
flushes of the face and nervousness. These symptoms result 
from the absence of the internal secretion of the ovaries. 

Lutein 

This is a substance made from the corpus luteum of the 
ovaries of the cow. It is used to relieve painful and scanty 
menstruation and the nervous symptoms usually associated 
with this condition. 

Pituitary Extract 

This is a substance made from the pituitary gland of the 
ox. It is a small gland situated at the base of the brain. 

The posterior lobe of this gland secretes a substance into 
the blood which contracts the blood vessels and the uterus. 

Disturbed secretion of this lobe produces a peculiar group 
of symptoms, such as the change in some of the sexual 
characteristics of the individual. (Hypopituitarism.) 



SERUMS, VACCINES AND ORGANIC SUBSTANCES 627 

Disturbed secretion of the anterior lobe causes enlarge- 
ments of the hands and features, known as acromegaly. 

Dessicated Pituitary Substance (anterior lobe) 0.06-0.3 gm. grs.i-v 
This is used in the treatment of acromegaly. 

Dessicated Pituitary gland (posterior lobe) 0.06-0.3 gm. grs. i-v 
This is used in the treatment of hypopituitarism. 

Pituitary Body Dessicated 0.06-0.3 gm. grs. i-v 

Pituitrin 

These substances are used to increase uterine contractions. 

Thymus 

Thymus m a powder made from the fresh thymus of the 
calf. It is a gland situated in the chest behind the sternum 
and probably regulates the growth of the child. It is used 
in the treatment of rheumatism and rickets. 

SWEETENING SUBSTANCES 

Saccharin (Benzosulphinidum) : This is a chemical sub- 
stance having a very sweet taste. It is 200 times sweeter 
than sugar and is used to sweeten foods for diabetic patients 
who cannot take sugar. It is usually given in 0.03 gm. (gr. §) 
doses together with 0.3 gm. (grs. v) of sodium bicarbonate, 
since it dissolves more readily in alkaline solutions. 

Saccharum Lactis (Milk Sugar) : used to flavor substances 
and to give consistency to powders. , 



INDEX 



(The most important reference is given first') 



A. B. and S. pill, 107 
Abbreviations of terms used 

in orders, 25 
Abbreviations of terms used 

in prescriptions, 25 
Absinthe, 176 
Absolute alcohol, 242 
Absorptionof drugs, 66, 11, 12 
A. C. E. mixture, 395 
Acetal, 419 
Acetanilid, 444, 467 
Acetanilid poisoning, 446 
Acetic ether, 459 
Acetozone, 590 
Acetphenetedin, 447 
Acetum opii, 433 
Acetylparethoxy, 448 
Acetylsalicylic acid, 501 
Acid, agaric, 468 

arsenious, 147 

benzoic, 600 

boracic, 594 

boric, 594 

cacodylic, 148 

carbolic, 573 

chrysophanic, 607 

cinnamic, 601 

citric, 524 

filicic, 509 

gallic, 542, 527 

hydrocyanic, 364, 353, 
527 

kinotannic, 539 

lactic, 525 

nitric, 521, 517 

nitrohydrochloric, 521 

oxalic, 526 

phosphoric, 287 

picric, 593 

pyrogallic, 586 

salicylic, 494, 498 

sulphuric, 520, 517 

tannic, 538, 515 
Acids, 517, 59 
Acids, inorganic, 517 
Acids, mineral, 517 
Acids, organic, 522 
Acids, poisoning by, 518 
Acids, treatment of poisoning 

by, 519 
Acids, vegetable, 522 
Acidum boricum, 594 
Acidum hydrochloricum di- 

lutum, 520, 517 
Acidum nitricum dilutum, 
521, 517 



Acidum nitrohydrochloricum 

dilutum, 521, 517 
Acidum sulphuricum dilutum, 

520, 517 
Aconite, 345, 309 
Aconitine, 345, 349 
Aconite poisoning, 347 
Aconite poisoning, treatment 

of, 348 
Action, cumulative, 67 
Action of drugs, mode of, 66 
Active immunity, 618 
Active principles of drugs, 6 
Active principles of Digitalis, 

159 
Active principles of Opium, 

422 
Actol, 557 
Adalin, 377 
Adeps, 615 

Adeps benzoinatus, 615 
Adeps lanae, 615 
Adeps lanae hydrosus, 615 
Adhesive plaster, 552 
Administration of drugs, 8 
Adnephrin, 190 
Adonidin, 174 
Adonis vernalis, 174 
Adrenalin, 186 
Adrenalin chloride solution, 

189 
Adrenalin inhalant, 190 
Adrenalin ointment, 190 
Aether, 379 
Afridol, 587 
Agar-agar, 110 
Agar-agar with Calumba, 

110 
Agar-agar with Gentian, 110 
Agar-agar with Phenolph- 

thalein, 110 
Agaric acid, 468 
Agaricin, 468 
Agaricus, 468 
Agurin, 333 
Airol, 565, 593 
Albargin, 556 
Albolene, 615 
Alcohol, 233, 185. 579 
Alcohol, Amy], 246 
Alcohol, Butyl, 246 
Alcohol, Ethyl, 233, 185, 579 
Alcohol, Methyl, 246 
Alcohol poisoning, Acute, 236 
Alcohol poisoning, treatment 

of, 238 
Alcohol, Propyl, 246 
Alcoholic beverages, 242 



Alcoholism, 238 

Ale, 245 

Aleuronat, 624 

Alkalies, 528, 59 

Alkalies, poisonous effects of, 
532 

Alkaline earths, 533 

Alkaloids, 7 

Alkaloids of Opium, 433 

Allium, 211 

Aloes, 106 

Aloin, 107 

Alphozone, 590 

Alteratives, 290, 62 

Althaea, 613 

Alum, 558, 515, 95 

Alum, dried, 559 

Alumen, 559 

Alumen exsiccatum, 559 

Aluminium, 558 

Aluminium acetate, Solution 
of, 559, 5S8 

Aluminium naphtholsulpho- 
nate, 559, 587 

Aluminium sulphate, 559 

Alumnol, 559, 587 

Alypin, 402 

American hellebore, 349 

Ammonia, 179 

Ammonia liniment, 183 

Ammonia poisoning, LSI 

Ammonia poisoning, treat- 
ment of, 182 

Ammonia water, lS.'i 

Ammoniated tincture of Val- 
erian, 454 

Ammonium, 179 

Ammonium acetate solution, 
183 

Ammonium benzoate, 601 

Ammonium bromide, 875, 377 

Ammonium carbonate. 1M 

Ammonium chloride, 199, 184 

Ammonium ichthosulpho- 
nate, 584 

Ammonium iodide, 492 

Amygdala amara, 77 

Amygdala dolcis, 614 

Amygdalin. 73, 78, 364 

Amylene chloral, 41!) 

Amylena hydrate, 416, 364 

Amyl nitrite, 354, 357 

Amylop-in, 83 

Amy him, 614 

Anaesthesin, 404 

Anaesthetic mixtures, 395 

Anaesthetics, 379, » 

Anaesthetics, general, 379 

629 



630 



INDEX 



Anaesthetics, local, 398 

Anaesthol, 395 

Analeptics, 62 

Analgen, 450 

Analgesics, 62 

Anchylostoma duodenale, 515 

Anise, 80 

Anisotonic solution, 112 

Anodynes, 421, 62 

Antacids, 528, 62, 59 

Anthelmintics, 507, 62, 58 

Anthemis, 74 

Anthrasol, 587 

Antiaris, 158 

Antiarthritics, 62 

Antidiphtheritic globulins, 
621 

Antidyssenteric serum, 620 

Antifebrine, 444 

Antiformin, 586 

Antigonococcus serum, 619 

Antikamnia, 450 

Antilithics, 62 

Antimeningococcus serum, 
620 

Antimony, 94, 309, 611 

Antimony and potassium tar- 
tarate, 94 

Antinervine, 450 

Antiperiodics, 62 

Antiphlogistine, 614 

Antipyretics, 439, 62, 56 

Antipyretics, comparative ac- 
tion of, 452 

Antipyretics, uses of, 451 

Antipyrine, 441, 467 

Antipyrine cum ferro, 444 

Antipyrine mandelate, 459 

Antipyrine poisoning, 443 

Antipyrine salicylate, 444, 
502 

Antirabic vaccine, 624 

Antiseptics, 567, 60, 63 

Antiseptin, 592 

Antiseptol, 592 

Antisialogogues, 63 

Antispasmodics, 453, 63 

Antistaphylococcua serum, 
619 

Antistreptococcus serum, 619 

Antithyroidin Moebius, 626 

Antitoxic serum, 620 

Antitoxins, 620, 61 

Antityphoid serum, 620 

Antizymotics, 63 

Apenta water, 116 

Aperients, 98, 63 

Apinol, 598 

Apiol, 329 

Apioline, 329 

Apnoea, 194 

Apocodein hydrochloride, 213 

Apocynum, 173, 331 

Apomorphine, 91 

Apomorphine hydrochloride, 
91 

Apothecaries equivalents of 
Metric units, 19 

Apothecaries fluid measure- 
ment, 18 

Apothecaries system of meas- 
urement, 18 



Apothecaries weight measure- 
ment, 18 

Approximate Apothecaries 
equivalents of Metric 
units, 20 

Approximate Metric equiva- 
lents of Apothecaries 
units, 19 

Aqua ammoniae, 183 

Aqua ammoniae fortior, 183 

Aqua camphorae, 178 

Aqua cinnamomi, 78 

Aqua fortis, 521 

Aqua hamamelis, 545 

Aqua hydrogeni dioxidi, 589 

Aqua menthae piperitae, 78 

Araroba, 607 

Arbutin, 338 

Argentamin, 556 

Argenti ichthosulphonas, 557 

Argenti nitras, 555 

Argenti proteinas, 557 

Argentum, 552 

Argonin, 557 

Argyria, 554 

Argyrol, 556 

Aristochin, 478 

Aristol, 592 

Arnica, 352 

Aromatic bitters, 73, 70 

Aromatic elixir, 82 

Aromatic powder, 81 

Aromatic spirit of ammonia, 
183 

Aromatics, 63 

Arrow poison, 167 

Arsenic, 141 

Arsenic iodide, 148 

Arsenic poisoning, Acute, 143 

Arsenic poisoning, Chronic, 
146 

Arsenic poisoning, treatment 
of, 145 

Arsenic tolerance, 143 

Arsenic trioxide, 147 

Arsenious acid, 147 

Arsenobenzol, 148, 493 

Arsen triferrin, 148 

Artificial alkaloids of Mor- 
phine, 435 

Artificial Carlsbad salts, 114 

Asafoetida, 455 

Asaprol, 450 

Ascarides, 507 

Asparagin, 340 

Aspidium, 508 

Aspidium filix mas, 508 

Aspidium poisoning, 508 

Aspidosperma, 195 

Astringents, 538, 59, 63 

Atophan, 506 

Atoxyl, 148 

Atropa belladonna, 247 

Atropine, 247, 257, 260, 265, 
184, 467 

Atropine, Appearance of pa- 
tient, 248 

Atropine group of drugs, 247 

Atropine ointment, 257 

Atropine poisoning, 252 

Atropine poisoning, treat- 
ment of, 254 



Atropine Sulphate, 257 
Attention, mode of action, 

219 
Aurantii amari cortex, 79 
Aurantii dulcis cortex, 79 
Aurum, 288 

Autogenous vaccines, 621 
Azedarach, 514 



B 



Bacillus Bulgaricus, 623 
Bacillus Coli vaccine, 622 
Balsam of fir, 336 
Balsam of Peru, 207 
Balsam of Tolu, 208 
Balsamum Traumaticum, 601 
Base of a salt, 371 
Basham's mixture, 136 
Basis of a prescription, 24 
Bearberry, 338 
Bebeerine, 478 
Beer, 245 
Belladonna, 248 
Belladonna, Appearance of 

patient, 248 
Belladonna, extract of, 256 
Belladonna liniment, 257 
Belladonna plaster, 256 
Belladonna poisoning, 252 
Belladonna, tincture of, 256 
Benzanilide, 450 
Benzoate of soda, 600 
Benzoic acid, 600 
Benzoin, 601, 596, 214 
Benzoinated lard, 615 
Benzolsulphinidum, 627 
Berberine, 71, 322 
Berberis, 71 
Beta Eucaine, 401 
Beta Eucaine hydrochloride, 

401 
Beta Eucaine lactate, 401 
Betanaphthol T 596 
Betanaphthol benzoate, 596 
Betol, 501, 596 
Bhang, 436 
Bichloride of Mercury, 484, 

579, 588 
Biniodide of Mercury, 485 
Bismal, 565 
Bismon, 566 
Bismuth, 563 
Bismuthal, 566 
Bismuth and Ammonium cit- 
rate, 565 
Bismuth and Iron Citrate, 

566 
Bismuth Beta Naphtholate, 

565 
Bismuth bitannate, 566 
Bismuth cresolate, 593 
Bismuth iodosubgallate, 565 
Bismuth methylen digallate, 

565 
Bismuth paste, 564 
Bismuth phenolate, 593 
Bismuth poisoning, 564 
Bismuth subcarbolate, 593 
Bismuth subcarbonate, 565 
Bismuth subgallate, 565, 593 



INDEX 



631 



Bistouth subnitrate, 565 

Bismuth tribromphenolate, 
566 

Bitter almonds, 77 

Bitter cucumber, 119 

Bitters, 69, 70, 63 

Blackberry, 545 

Black drop, 433 

Black haw, 467 

Black snake root, 457 

Black wash, 486 

Blaud's pills, 134 

Bleaching powder, 572 

Blindness following wood al- 
cohol poisoning, 246 

Blood and circulatory stimu- 
lants, 127 

Blood, formation of, 127 

Blood, function of, 127 

Blood root, 212, 436 

Blood stimulants, 128 

Blue gum tree, 74, 597 

Blue mass, 485, 104 

Blue ointment, 485 

Blue stone, 563 

Blue vitriol, 563 

Body temperature, mode of 
production, 439 

Body temperature, method of 
regulating, 439 

Boneset, 74 

Bonjean's extract of Ergot, 
320 

Boracic acid, 594 

Borax, 594 

Boric acid, 594 

Boric acid ointment, 595 

Bornyval, 454 

Boroglycerine, 595 

Boro salicyl solution, 499, 588 

Bougies, 9 

B. P., 5 

Brain, functions of, 216 

Brain, motor action of, 218 

Brain, sensory action of, 
216 

Brain tonics, 281 

Brandy, 243 

Braun's solution, 400 

Brayera, 509 

Brimstone, 100 

British Pharmacopoeia, 5 

Bromal hydrate, 409 

Brometone, 377 

Bromides, 371, 364, 419 

Bromides, Appearance of pa- 
tient, 372 

Bromides, poisonous symp- 
toms of, 374 

Bromidia, 378 

Bromine, 572, 611 

Bromiol, 377 

Bromipin, 377 

Bromism, 374 

Bromocoll, 378 

Bromoform, 415 

Bromo mangan, 378 

Bromural, 378 

Broom tops, 334 

Brovalol, 378, 454 

Brown's mixture, 433, 613 

Brucine, 273 



Buchu, 603, 344 
Bulgaric tablets, 623 
Burgundy wine, 245 
Burnt alum, 559 
Burrow's solution, 559, 588 
Butyl chloral hydrate, 409 



Cachet, 3 

Cacodyl (Arsenic) deriva- 
tives, 148 

Cacodylic acid, 148 

Caffeine, 153, 333 

Caffeine citrate, 157 

Caffeine sodium benzoate, 
157 

Calabar bean, 310 

Calcii sulphas exsiccatus, 617 

Calcined magnesia, 114, 537 

Calcium bromide, 377 

Calcium chloride, 536 

Calcium glycerophosphate, 
287 

Calcium hypophosphite, 287 

Calcium ichthyol, 584 

Calcium lactate, 536 

Calcium peroxide, 589 

Calendula, 293 

California buckthorn, 99 

Calomel, 103, 484, 343, 516 

Calomelol, 487 

Calumba, 71, 515 

Calx, 533 

Calx chlorinata, 572 

Camelia thea, 547 

Camphor, 176 

Camphorated tincture of Opi- 
um, 432 

Camphoric acid, 469 

Camphor liniment, 179, 609 

Camphor oil, 179 

Camphor spirits, 179 

Camphor, use of in Pneu- 
monia, 178 

Camphor water, 178 

Cannabinol, 436 

Cannabis indica, 436 

Canada balsam, 336 

Canada turpentine, 336 

Canadian hemp, 173 

Cantharides, 609, 344 

Cantharides collodion, 610 

Cantharis, 610 

Cantharis vittata, 610 

Caoutchouc, 617 

C. A. P. capsule, 451 

Capsicum, 76, 609 

Capsule, 3 

Carbohydrate preparations, 
300 

Carbohydrates, 296 

Carbolic acid, 573 

Carbolic acid derivatives, 576 

Carbolic acid ointment, 576 

Carbolic acid poisoning, 574 

Carbolic acid poisoning, treat- 
ment of, 575 

Carbo ligni, 598 

Cardamomum, 77 

Cardamom, 77 



Cardiac depressants, 345, 
353, 63 

Cardiac sedatives, 345, 353, 
63 

Cardiac stimulants, 153 

Cardiac stimulants, compara- 
tive action of, 191 

Cardiac stimulants, table of, 
191 

Cardio accelerator center of 
medulla, 223 

Cardio inhibitory center of 
medulla, 223 

Carlsbad salt, 114 

Carlsbad water, 116 

Carminative action, 75 

Carminatives, 75, 63 

Carolina jasmine, 460 

Carrageenin, 614 

Carragheen, 614 

Carraway seeds, 81 

Carum, 81 

Caryophylus, 80 

Cascara, 99 

Cascara sagrada, 99 

Casoid diabetic flour, 296 

Cassia fistula, 100 

Castor oil, 101 

Castor oil cocktail, 103 

Cataplasma kaolini, 614 

Catechu, 543 

Catechutannic acid, 539 

Cathartic enemata, 125 

Cathartics, 96, 63 

Cathartics, administration of, 
97 

Cathartics, classification of, 
98 

Cathartics, drastic, 117 

Cathartics, saline, 111 

Cathartics, vegetable, 101 

Cathartic vegetable pills, 123 

Caustic potash, 531 

Caustic soda, 530 

Caustics, 611, 63 

Cayenne pepper, 76 

Celandine, 436 

Centers of Medulla Oblon- 
gata, 223 

Cera alba, 616 

Cera flava, 616 

Cerate of lead subacetate, 552 

Ceratum, 616 

Cerebellum, action of, 222, 
215 

Cerebral depressants, 371, 63 

Cerebral stimulants, 233 

Cerebral stimulation, 227 

Cerebral tonics, 281 

Cerebrum, action of, 216 

Cerium oxalate, 566 

Cetacum, 616 

Cetrarin, 72 

Cevadilla, 351 

Chalk, 534 

Chalk mixture, 536 

Chamomile, 74 

Champagne, 244 . 

Charcoal, 598 

Charta, 2 

Chenopodium, 514 

Cherry water, 82 



632 



INDEX 



Chimaphila, 339 

Chinosol, 587 

Chirata, 71 

Chloral, 405, 364 

Chloral, Appearance of pa- 
tient, 405 

Chloral camphor, 409 

Chloral collapse, 407 

Chloral, dangers in use of, 407 

Chloralformamid, 409 

Chloral hydrate, 405, 409 

Chloral poisoning, 407 

Chloralose, 410 

Chloretone, 417 

Chlorinated lime, 572 

Chlorine, 570 

Chlorine water, 572 

Chlorodyne, 392 

Chloroform, 387 

Chloroform, administration 
of, 391 

Chloroform anaesthesia, 387 

Chloroform collapse, 390 

Chloroform collapse, treat- 
ment of, 391 

Chloroform, comparison of 
action with Ether, 393 

Chloroform liniment, 393 

Chlorum, 570 

Cholagogue cathartics, 101 

Cholagogues, 63 

Chondrus, 614 

Christmas rose, 158 

Chromic acid, 611 

Chronic Cocaine poisoning, 
271 

Chronic Iodine poisoning, 581 

Chronic Mercury poisoning, 
483 

Chronic Mercury poisoning, 
treatment of, 483 

Chronic Opium poisoning, 
429 

Chronic Wood alcohol poi- 
soning, 246 

Chrysarobin, 607 

Chrysophanic acid, 607 

Churrus, 436 

Cicutoxin, 280 

Cimicifuga, 457 

Cinchona, 471 

Cinchona calisaya, 471 

Cinchona rubra, 471 

Cinchonidine, 472 

Cinchonine, 471 

Cinnamic acid, 601 

Cinnamon, 78 

Cinnamon water, 78 

Ciose, 296 

Circulation of the blood, 148 

Circulatory stimulants, 127 

Citrate of Magnesia solution, 
115 

Citric acid, 524 

Citrine ointment, 486 

Classification of drugs, 53 

Cloves, 80 

Club moss, 614 

Coal tar, 441 

Coal tar derivatives, 441 

Coca, 267 

Cocaine, 272, 267, 399 



Cocaine, Appearance of pa- 
tient, 267 

Cocaine habit, 271 

Cocaine hydrochloride, 273 

Cocaine poisoning, Acute, 270 

Cocaine poisoning, treatment 
of, 271 

Cocoa butter, 616 

Codeine, 434, 422, 364 

Codeine phosphate, 434 

Codeine sulphate, 434 

Cod liver oil, 301 

Cod liver oil, administration 
of, 302 

Coffee, 153 

Coffee habit, 156 

Cognac, 243 

Colchicine, 505 

Colchicum, 502 

Colchicum seeds, 504 

Colchicum steins, 504 

Cold cream, 79 

Coley's serum, 622 

Collargol, 556 

Collargol ointment, 556 

Collodion, 617 

Collodion flexile, 617 

Collodium, 617 

Collodium cantharidatum, 
610 

Colloidal Bismuth oxide, 566 

Colloidal Calomel, 487 

Colloidal Silver, 556 

Colocynth, 119 

Colocynthin, 119 

Comparative action of Anti- 
pyretics, 452 

Comparative action of Atro- 
pine group, 266 

Comparative action of Chlo- 
roform and Ether, 393 

Comparative action of Digi- 
talis group, 175 

Comparative action of Sal- 
icylates, 500 

Complex emotions, mode of 
action, 221 

Compound Acetanilid pow- 
der, 447 

Compound cathartic pills, 123 

Compound Chloroform lini- 
ment, 393 

Compound Effervescent pow- 
der (Seidlitz Powder) , 
115 

Compound Fluidextract of 
Sarsaparilla, 291 

Compound Iodine solution, 
582 

Compound Iron mixture, 136 

Compound Licorice powder, 
109 

Compound Morphine pow- 
der, 434 

Compound Rhubarb powder, 
106 

Compound Spirits of Ether, 
458 

Compound Syrup of Hypo- 
phosphites, 287 

Compound Syrup of Sarsa- 
parilla, 291 



Compound tincture of Ben- 
zoin, 601 

Compound tincture of Opi- 
um, 433 

Condurango, 72 

Confection of Senna, 108 

Confections, 3 

Conium, 462 

Conium poisoning, 462 

Conquinine, 471 

Conscious actions, nature of, 
224 

Consciousness, 219 

Convallamarin, 171 

Convallaria, 171 

Convallarin, 171, 173 

Convolvulin, 117 

Convulsants, 63 

Convulsions, 228 

Convulsions, clonic, 228 

Convulsions, tonic, 228 

Copaiba, 602, 344 

Copper, 562 

Copper sulphate, 563, 95, 611 

Cornsilk, 339 

Cornutine, 314, 316 

Cornutol, 320 

Coronillin, 340 

Corpus luteum, 626 

Corrective of a prescription, 24 

Correctives, 64 

Corrosive sublimate, 484, 
579, 588 

Cotarnine hydrochloride, 324 

Cotarnine phthalate, 324 

Cotton root bark, 325 

Cotton seed oil, 616 

Couch grass, 339 

Coughing, mechanism of, 194 

Counter-irritants, 607, 64 

Cramp root, 467 

Cream of tartar, 341, 113 

C rede's ointment, 556 

Cremo bismuth, 565 

Creolin, 577 

Creosotal, 599 

Creosote, 598 

Creosote carbonate, 599 

Cresol, 501 

Cresols, 576 

Cretinism, 625 

Croton oil, 124 

Croton oil, administration of, 
125, 611 

Croton oil poisoning, 124 

Crurin purum, 566 

Cubebs, 602, 344 

Cumulative action of a drug, 
67 

Cumulative symptoms, 67 

Cupri sulphas, 563 

Cuprum, 562 

Curara, 466 

Cusso, 509 

Cyanosis, nature of, 194 

Cycloform, 404 

Cypripedium, 459 

D 

Dandelion, 335 
Daphnin, 292 



INDEX 



633 



Datura stramonium, 248 

Deadly nightshade, 248 

Dead tongue. 280 

Decigramme, 17 

Decoction of Scoparius, 334 

Decoctions, 5 

Delayed Chloroform poison- 
ing, 391 

Delirifacients, 64 

Delirium, nature of, 228 

Delirium tremens, 240 

Delphinine, 349 

Delphinium, 349 

Demulcents, 612, 61, 64 

Deodorants, 567, 64 

Deodorized Opium, 431 

Deodorized tincture of Opi- 
um, 432 

Depilatories, 64 

Depressants, 345, 53 

Depression, 53 

Depression of blood forming 
organs, 128 

Depression of Cardio acceler- 
ator center, 232 

Depression of Cardio inhibi- 
tory center, 232 

Depression of medulla ob- 
longata, 232 

Depression of mental func- 
tions of brain, 231 

Depression of nerves, 232 

Depression of nerve endings, 
232 

Depression of sensations, 
231 

Depression of speech center, 
231 

Depression of spinal cord, 232 

Depresso motors, 460, 64 

Depurants, 64 

Dermatol, 565, 593 

Dermol, 593 

Dessicated Pituitary gland, 
627 

Dessicated Pituitary sub- 
stance, 627 

Detergents, 64 

Dextrose, 300 

Diabetic flour, 624 

Diabetin, 300 

Diachylon ointment, 552 

Diachylon plaster, 552 

Diagram illustrating action of 
Nervous system, 225 

Diaphoretics, 304, 309, 64 

Diaspirin, 501 

Diastole of heart, 150 

Diazyme, 86 

Diethyl Barbituric acid, 417 

Diffusion, 528 

Digalen, 166 

Digestants, 83, 64 

Digestion, 69 

Digestion of proteids, 84 

Digestion of starches, 83 

Digestives, 83, 64 

Digipuratum, 167 

Digitalin, 159 

Digitalins, 167 

Digitaliresin, 280 

Digitalis, 159, 331 



Digitalis, action on circula- 
tion, 160 

Digitalis, administration of, 
164 

Digitalis, Appearance of pa- 
tient, 165 

Digitalis, cumulative action, 
163 

Digitalis, Fluidextract of, 166 

Digitalis group, 158 

Digitalis group, table of com- 
parative action, 175 

Digitalis, Infusion of, 166 

Digitalis poisoning, 163 

Digitalis, Tincture of, 166 

Digitol, 167 

Digitonin, 159 

Digitophyllin, 159 

Digitoxin, 159, 167 

Dilute Acetic acid, 522 

Dilute Hydrobromic acid, 376 

Dilute Hydrochloric acid, 520 

Dilute Hydrocyanic acid, 368, 
364, 353 

Dilute Nitric acid, 521 

Dilute Nitrohydrochloric 
acid, 521 

Dilute Phosphoric acid, 287 

Dilute Sulphuric acid, 520 

Dimethy laminoantipyrina , 
449 

Dimethyl Piperazine tartar- 
ate, 505 

Dionin, 435 

Diosphenol, 603 

Diphtheria Antitoxin, con- 
centrated, 621 

Diphtheria Antitoxin serum, 
620 

Disinfectants, 567, 64, 60 

Dispensatory, 6 

Distillation, 233 

Diuretics, 331, 64 

Diuretin, 333 

Dobell's solution, 595, 596 

Donovan's solution, 147, 485 

Dormiol, 419 

Dosage, 13 

Dosage, conditions influenc- 
ing, 13 

Dosage, Young's rule for, 14 

Dover's powder, 431, 90 

Drachm, 18 

Drastic cathartics, 117 

Drastic purgatives, 117 

Dried alum, 559 

Dried Suprarenal gland, 189 

Drugs acting on the blood, 55 

Drugs acting on the blood 
vessels, 55 

Drugs acting on the brain, 55 

Drugs acting on the gastero 
intestinal tract, 54 

Drugs acting on the genital 
organs, 57 

Drugs acting on the heart, 55 

Drugs acting on the kidneys, 
57 

Drugs acting on the nervous 
system, 55 

Drugs acting on the respira- 
tion, 55 



Drugs acting on the secretory 
glands, 56 

Drugs, administration of, 8 

Drugs, Dosage of, 13 

Drugs, Idiosyncrasies of, 14 

Drugs which destroy hook 
worms, 515 

Drugs which destroy thread 
worms, 515 

Drugs which increase the ac- 
tion of involuntary mus- 
cles, 310 

Dry red wines, 244 

Dry Thiol, 585 

Dry white wines, 244 

Dry wines, 244 

Duboisia, 265, 248 

Duboisine, 265 

Duotal, 599 

Dyer's oak, 538 

Dyspnoea, 193 



Eau de Cologne, 246 

Ecbolics, 64 

Effervescent draught, 341 

Effervescent Magnesium sul- 
phate, 115 

Effervescent Potassium cit- 
rate, 341 

Effervescent Lithium citrate, 
342, 116 

Effervescent Saline purga- 
tives, 115 

Effervescent Sodium phos- 
phate, 115 

Elastica, 617 

Elaterine, 122 

Elaterium, 122 

Elixir Aromaticum, 82 

Elixir of Enzymes, S5 

Elixir of Iron, Quinine and 
Strychnine phosphate, 
137, 280, 477 

Elixirs, 4 

Elm, 612 

Emetics, 88, 64 

Emetine, 88, 90 

Emmenagogues, 314, 325, 64 

Emollients, 615, 61, 64 

Emotions, nature of, 220 

Emplastrum, 2 

Emplastrum adhaesivum, 552 

Emplastrum belladonnae, 256 

Emplastrum capsi< i, 77 

Emplastrum plumbi, 552 

Emulsin, 73, 364, 614 

Emulsion of Chloroform, 392 

Emulsion of Cod liver oil, 302 

Emulsion of Cod liver oil with 
Hypophosphites, 302 

Emulsions, 4 

Emulsum Olei Morrhuae cum 
Hypophosphitibus, 302 

Encephalopathia saturnina, 
550 

Enemata, 125 

Enemata, cathartic, 125 

Enemata, nutritive, 125 

Enemose, 298 



634 



INDEX 



Epinephrine, 190 

Epispastics, 64 

Epsom salts, 114 

Ergot, 314 

Ergot, Appearance of patient, 

315 
Ergotin, 320 
Ergotole, 320 
Ergot poisoning, 317 
Ergotinine citrate, 320 
Ergotoxin, 320 
Ericin, 501 
Eriodictyon, 213 
Ernutin, 320 
Errhines, 64 

Erythrol tetranitrate, 363 
Erythroxylon coca, 267 
Escharotics, 611, 64 
Eserine, 310, 353 
Eserine salicylate, 313 
Eserine sulphate, 313 
Essence of pepsin, 85 
Essential salt of lemon, 526 
Ether, 379, 398 
Ether, administration of, 385 
Ether anaesthesia, 379 
Ether, Appearance of patient, 

379 
Ether, Bromide of, 393 
Ether, Chloride of, 394 
Ether collapse, 384 
Ether, comparison of action 

with Chloroform, 393 
Ether, Compound spirits of, 

458 
Ether, dangers of, 384 
Ether poisoning, 384 
Ethyl bromide, 393 
Ethyl carbamate, 415 
Ethyl chloride, 394, 398 
Ethylenediamine tricresol, 

577 
Ethyl salicylate, 501 
Eucaine, 400, 273 
Eucalyptol, 597, 596 
Eucalyptus, 74, 214 
Eucalyptus, Oil of, 598 
Eucodein, 434 
Eudoxin, 593 
Eunatrol, 309 
Euonymus, 99 
Eupatorium, 74, 308 
Eupthalmin, 273 
Euquinine, 478 
Euresol, 586 
Europhen, 592 
Euscopole, 265 
Evacuants, 65 
Exalgine, 450 
Examples of administering 

doses from a limited 

number of tablets, 41 
Examples of calculating doses 

from stock solutions, 43 
Examples of calculating 

stronger doses from stock 

solutions, 47 
Examples of calculating 

weaker doses from stock 

solutions, 46 
Examples of calculating doses 

from stock tablets, 40 



Examples of fluid prescrip- 
tions, 27 

Examples of making solu- 
tions from other solu- 
tions, 37 

Examples of making solutions 
from powders, 36 

Examples of making solutions 
from tablets, 34 

Examples of reducing Apoth- 
ecaries quantities to their 
Metric equivalents, 23 

Examples of reducing Met- 
ric quantities to their 
Apothecaries equiva- 
lents, 21 

Examples of solid prescrip- 
tions, 29 

Excito motors, 64 

Excretion, 66 

Exodyne, 450 

Exophthalmic goitre, 625 

Exophthalmos, 626 

Expectorants, 198, 214, 64, 
369 

Expectorants, sedative, 369 

Expectorants, stimulat ing, 
198 

Extract of Belladonna, 256 

Extract of Digitalis, 166 

Extract of Nux Vomica, 279 

Extract of Opium, 431 

Extract of Witch hazel, 545 



Fats, 301, 296 

Febrifuges, 65 

Fel bovis, 99 

Fennel, 81 

Fermentation, 233 

Fermented liquors, 243 

Ferratin, 138 

Ferrichthyol, 584 

Ferri et Potassii tartaras, 135 

Ferri et Quininae citras, 135 

Ferri et Strychninae citras, 

135 
Ferri hydroxidum cum Mag- 

nesii oxido, 137 
Ferri subsulphatis, 134 
Ferri sulphas, 134 
Ferro mangan, 138 
Ferropyrine, 444 
Ferro sajodin, 492 
Ferrous lactate, 138 
Ferrum, 131 
Fever, cause of, 440 
Fibrolysin, 295 
Filicic acid, amorphous, 509 
Filix mas, 508 
Filmaron, 509 
Fixed oil, 101, 124 
Flavoring substances, 79 
Flaxseed, 613 
Flaxseed meal, 613 
Flexible collodion, 617 
Flowers of sulphur, 100 
Fluidextract of Belladonna, 

256 
Fluidextract of Digitalis, 166 



Fluidextract of Ergot, 319 
Fluidextracts, 4 
Foeniculum, 81 
Food principles, 296 
Formaldehyde, 568 
Formaldehyde poisoning, 568 
Formalin, 569 
Formation of blood, 127 
Formulary, 6 
Fothergill's pill, 344, 171 
Fowler's solution, 147 
Frangula, 98 
Friar's balsam, 601 
Fruit sugar, 300 
Fuller's earth, 614 
Function of stomach, 69 

G 

\ 

Galactogogues, 65 

Galla, 542 

Gall and Opium ointment, 
543 

Gallic acid, 542, 527 

Gallogen, 542 

Gall oak, 542, 538 

Gallotannic acid, 539 

Gambir, 543 

Gamboge, 121 

Gambogia, 121 

Garden lettuce, 436 

Gas ether method of anaes- 
thesia, 386 

Gastero intestinal stimulants, 
69, 54 

Gastric stimulants, 69 

Gaultheria, 80, 498 

Gelatine, 299 

Gelatine, glycerinated, 299 

Gelatine tannate, 541 

Gelatinose silver, 556 

Gelsemenine, 460 

Gelsemine, 460 

Gelsemium, 460 

Gelsemium poisoning, 461 

General anaesthesia, 379 

General anaesthetics, 379 

General effects of drugs, 9 

Genito urinary antiseptics, 
600 

Gentian, 70 

Geranium, 545 

Germicides, 567, 60 

Gin, 243 

Ginger, 77 

Glacial Acetic acid, 524, 611 

Glandulae Suprarenalis sic- 
cae, 189 

Glandulae Thyroidae siccae, 
626 

Glauber's salt, 113 

Glonoin, 361 

Glonoin, Spirits of, 361 

Glucosides, 7 

Glucosides of Digitalis, 159 

Glycerine, 616, 100 

Glycerite of Egg yolk, 616 

Glycerite of Phenol, 576 

Glycerite of starch, 616 

Glycerite of Tannic acid, 540 

Glycerites, 5 



INDEX 



635 



Glyceritum amyli, 616 
Glyceritum boroglycerini, 595 
Glyceritum vitelli, 616 
Glycerole of Lecithin, 303 
Glycerophosphates, 287 
Glycerophosphoric acid, 287 
Glyco thymoline, 595 
Glycyrrhiza, 613, 109 
Glycyrrhizin, 613, 109 
Goa powder, 607 
Gold, 288 
Gold chloride, 289 
Gold and Potassium bromide, 

289 
Gold and Sodium chloride, 

289 
Golden seal, 320 
Gonococcus vaccine, 622 
Gossypium, 325 
Goulard's extract, 552 
Gout, 503 
Grain, 18 
Gramme, 17 
Granatum, 510 
Grape juice, 525 
Grave's disease, 625 
Gray powder, 485, 105 
Green hellebore, 349 
Griffith's mixture, 136 
Grindelia, 369, 353 
Guarana, 157 
Guiacol, 599, 399 
Guiacol carbonate, 599 
Guiacol cinnamate, 599 
Guiacol salol, 599 
Guiac resin, 291 
Guiajasanol, 599 
Guiamar, 599 
Gum arabic, 612 
Gunjah, 436 
Guy's pills, 344, 171 
Gynoval, 454 
Gypsum, 258, 617 

H 

Haemaboloids, 138 

Haematinics, 128 

Haematoxylon, 545 

Haemogallol, 138 

Haemoglobin of the blood, 
function of, 127 

Haemostatics, 65 

Hallucinations, nature of, 227 

Hamamelis, 544 

Hashish, 436 

Headache powders, ingredi- 
ents of, 449 

Heart, action of, 149 

Heart action, conditions in- 
fluencing it, 150 

Heart depression, effects of, 
152 

Heart, effect of Vagus im- 
pulses on, 150 

Heart, inhibitory impulses of, 
150 

Heart, poisonous effects on, 
152 

Heart stimulants, 153 

Heart stimulation- 151 



Hedonal, 418 

Hegonon, 557 

Helleborus niger, 158 

Helmitol, 604 

Henbane, 260 

Heroin, 435 

Heroin hydrochloride, 435 

Hexal, 604 

Hexamethylenamine, 603 

Hoffman's anodyne, 458, 387 

Holadin, 87 

Holocain, 402 

Holocain hydrochloride, 402 

Homatropine, 257 

Homatropine hydrobromide, 

258 
Hook worms, 507 
Hops, 458, 73 
Horehound, 81, 214 
Hormonal, 110 
Hormone action, 111 
Humulus, 73, 458 
Humulus lupulus, 458, 73 
Hunjadi janos, 116 
Hunjadi water, 116 
Hydracetine, 450 
Hydragogue cathartics, 101 
Hydragogues, 65 
Hydrargyri benzoas, 487 
Hydrargyri chloridum cor- 

rosivum, 484, 579, 588 
Hydrargyri chloridum mite, 

103, 484, 343 
Hydrargyri cyanidum, 486, 

579 
Hydrargyri iodidum flavum, 

485 
Hydrargyri iodidum rubrum, 

485 
Hydrargyri nucleinas, 487 
Hydrargyri oxycyanidum, 

486, 579 
Hydrargyri subsulphas flav- 

us, 95 
Hydrargyri succinimidum, 

487 
Hydrargyrum, 479 
Hydrastine, 321 
Hydrastinine, 323 
Hydrastinine hydrochloride, 

323 
Hydrastis, 320 
Hydrobromic acid, 376 
Hydrochloric acid, 530, 517 
Hydrochloric acid poisoning, 

518 
Hydrochloric acid poisoning, 

treatment of, 519 
Hydrocyanic acid, 364, 353, 

527 
Hydrocyanic acid poisoning, 

366 
Hydrogen dioxide, 588 
Hydrogen peroxide, 588 
Hydroquinone, 586 
Hyoscine, 263, 247, 248, 260 
Hyoscine hydrobromide, 264 
Hyoscyamine, 262, 248, 265 
Hyoscyamus, 260 
Hyoscyamus niger, 247 
Hypnone, 416 
Hypnotics, 405, 65, 56 



Hypnotics, comparative ac- 
tion of, 420 

Hypodermic injection, meth- 
od of administration, 11 

Hypodermoclysis, 130 

Hypophosphites, 287 

Hypophosphorous acid, 287 

Hypopituitarism, 626 

Hysteria, 453 



Iceland moss, 72 

Ichthalbin, 584 

Ichthargan, 557, 5S4 

Ichthoform, 584 

Ichthyol, 583 

Idiosyncrasy, 14 

Igasuric acid, 273 

Illusions, nature of, 227 

Illustration of hypodermicad- 
ministration, opposite, 48 

Imagination, nature of, 221 

Immunity, nature of, 618 

Immunization, active, 618 

Immunization, passive, 618 

Indian hemp, 436 

Indian poke, 349 

Indian tobacco, 464 

India rubber, 617 

Infusion of Digitalis, 166 

Infusion of Juniper, 336 

Ingluvin, 87 

Inhibition, nature of, 222 

Inhibitory impulses of the 
heart, 150 

Injections, method of admin- 
istration, 11 

Inorganic acids, 517 

Inorganic Iron preparations, 
134 

Inscription, 24 

Intestinal antiseptics, 596 

Intestinal stimulants, 96 

Intramuscular injection, 
method of giving, 10 

Intratracheal insufflation, use 
of in Morphine poison- 
ing, 429 

Intravenous infusion, 10, 129 

Intravenous injection, meth- 
od of administration, 9 

Iodalbin, 493 

Iodides, 487 

Iodides, cumulative symp- 
toms, 490 

Iodides, poisonous effects of, 
490 

Iodides, specific action in 
Syphilis, 488 

Iodine, 580 

Iodine ointment, 582 

Iodine poisoning, 581, 490 

Iodipin, 493 

Iodism, 490, 581 

Iodo casein, 492 

Iodoform, 691 

Iodoformogon, 592 

Iodoform ointment. 592 

Iodoform poisoning, 591 

Iodol. 592 



636 



INDEX 



Iodothyrin, 625 

Iodum, 580 

Ion action, 371 

Ions, 371 

Iothion, 493 

Ipecac, 88, 309 

Ipecac, preparations of, 90 

Ipecacuanha, 88, 309 

Irish moss, 614 

Iron, 131 

Iron, administration of, 133 

Iron and Potassium tartarate, 

135 
Iron and Quinine citrate, 135, 

477 
Iron and Strychnine citrate, 

135, 279 
Iron, Appearance of patient, 

132 
Iron hydroxide, 137 
Iron hydroxide with Mag- 
nesia oxide, 137 
Iron hypophosphite, 287 
Iron, incompatibilities of, 139 
Iron, inorganic preparations 

of, 134 
Iron, organic preparations of, 

138 
Iron subsulphate, 134 
Iron sulphate, 134 
Iron tropon, 138 
Irritants, 605 
Irritation, 53 
Isopral, 418 
Isotonic solution, 112 
Itrol, 557 



Jaborandi, 304 
Jalap, 117 
Jalapin, 117 
Jambul, 293 
Jamestown weed, 258 
Japaconitine, 345 
Javelle's solution, 572 
Jerusalem oak, 514 
Jesuit's drops, 601 
Judgment, nature of, 220 
Juniper, 335, 81 
Juniper berries, 335, 81 

K 

Kali jodatum (Potassium 
Iodide), 492 

Kalium (Potassium) com- 
pounds, 531 

Kalium (Potassium) salts, 
531 

Kamala, 511 

Kaolin, 614 

Kaolinum, 614 

Keely cure, 289 

Kefir fungus, 300 

Kilogramme, 17 

Kino, 544 

Kinotannic acid, 539 

Kirchwasser, 246, 82 

Knockout drops, 407 



Kola, 153 
Kousso, 509 
Krameria, 544 
Kresamine, 577 
Kummel, 82 
Kumyss, 300 



Labarracque's solution, 572 

Lac bismo, 565 

Lactampoule, 623 

Lactic acid, 525 

Lactic acid bacilli, 623 

Lactic bacillary tablets, 623 

Lactophenine, 450 

Lactucarium, 436 

Ladies' slipper, 459 

Lady Webster's dinner pill, 
107 

Lamellae, 4 

Lanolin, 615 

Lapactic pills, 107 

Lappa, 294 

Latin terms used in orders, 25 

Latin terms used in prescrip- 
tions, 25 

Laudanum, 432 

Laughing gas, 396 

Lavandula, 80 

Lavender, 80 

Laxatives, 98, 65 

Laxol, 102 

Lead, 547 

Lead acetate, 551 

Lead colic, 550 

Lead iodide, 552 

Lead paralysis, 550 

Lead plaster, 552 

Lead poisoning, Acute, 548 

Lead poisoning, Chronic, 549 

Lead poisoning, treatment of, 
551 

Lead subacetate solution, 552 

Lecibrin, 303 

Lecithin, 302 

Lecithol, 303 

Lemonade, 525 

Lemon juice, 524 

Lemon peel, 81 

Leptandra, 99 

Leucocyte extract, 624 

Levant wormseed, 512 

Levulose, 300 

Licorice, 613, 109 

Licorice root, 613, 109 

Liebig's meat juice, 297 

Light magnesia, 537, 114 

Lily of the valley, 171 

Lime, 533 

Lime and soda, 579 

Lime liniment, 536 

Lime water, 535, 515 

Limonis cortex, 81 

Liniments, 5 

Linimentum calcis, 536 

Linimentum camphorae, 179, 
609 

Linimentum saponis, 179 

Linseed, 613 

Linseed oil, 616 



Linum, 613 
Liqueurs, 246 

Liquidamber orientalis, 601 
Liquid extract of Ergot, 320 
Liquid Peptonoids, 298 
Liquid Thiol, 585 
Liquor Acidi arsenosi, 147 
Liquor Ammonii acetatis, 183 
Liquor Ammonii anisatus, 

201 
Liquor Antisepticus, 595 
Liquor Arseni at Hydrargyri 

iodidi, 147 
Liquor Calcis, 535 
Liquor Chlori Compositae, 

572 
Liquor Cresolis Compositus, 

577 
Liquor Digitoxin Solubilis, 

166 
Liquor Ferri et Amonii ace- 
tatis, 136 
Liquor Ferri subsulphatis, 

134 
Liquor Ferri tersulphatis, 

136 
Liquor Formaldehydi, 569 
Liquor Iodi Compositus, 582 
Liquor Magnesii citratis, 115 
Liquor Potassii arsenitis, 147 
Liquor Sodae chlorinatae, 572 
Liquor Sodii hydroxidi, 530 
Listerine, 595 
Lithium, 537 

Lithium benzoate, 342, 601 
Lithium bromide, 376 
Lithium carbonate, 342 
Lithium citrate, 342 
Lithium salts, 342 
Liver of Sulphur, 583 
Lobelia, 464, 370, 353 
Lobelia poisoning, 464 
Lobeline, 464 
Local administration of drugs, 

8 
Local anaesthetics, 398, 379 
Log wood, 545 
Losophan, 582 
Lotio Hydrargyri fiava, 486 
Lotio Hydrargyri nigra, 486 
Lozenges, 3, 9 

L. Suprarenin synthetic, 190 
Lubrichondrin, 614 
Lugol's solution, 582 
Lumbrici, 507 
Lumbricides, 512 
Lunar caustic, 555 
Lupulin, 458, 73 
Lupulus, 458, 73 
Lutein, 626 
Lycetol, 505 
Lycopodium, 614 
Lysoform, 578 
Lysol, 577 

M 

Magendie's solution, 434 
Magnesia, 537 
Magnesium oxide, 537, 114 
Magnesia usta, 537, 114 



INDEX 



637 



Magnesium citrate solution, 
115 

Magnesium peroxide, 589 

Magnesium salts, 537 

Magnesium sulphate, 114 

Malakine, 450, 501 

Malaria, 473 

Male fern, 508 

Malt, 83 

Maltine, 84 

Maltzyme, 84 

Mandragora, 266, 248 

Mandrake, 266, 248 

Manganese, 139 

Manna, 98 

Mannitol hexanitrate, 363 

Marigold, 293 

Marrubium, 81, 214 

Massa Hydrargyri, 104 

Massolin, 622 

Materia Medica, 1 

Matico, 603 

Matricaria, 74 

Matzoon, 300 

Maximum dose of a drug, 13 

May apple, 120 

McMunn's Elixir, 433 

Meadow saffron, 502 

Measurement of Apothecar- 
ies units, 20 

Measurement of Metric units, 
20 

Meat extracts, 298 

Meat juices, 297 

Medicinal foods, 296 

Medinal, 417 

Medulla oblongata, 215 

Medulla oblongata, action of, 
223 

Meltzer Auer method, use of 
in treatment of Mor- 
phine poisoning, 429 

Memory, nature of action, 
220 

Mental activities of the brain, 
219 

Mental activities of the brain, 
effect of depression on, 
231 

Mental activities of the brain, 
effect of stimulation on, 
229 

Mentha piperita, 78 

Menthol, 399 

Mercurialism, 483 

Mercurial ointment, 485 

Mercuric benzoate, 487 

Mercuric cyanide, 486, 579 

Mercuric oxycyanide, 486, 
579 

Mercuric salicylate, 486 

Mercuric sulphate ethylen- 
diamine, 579 

Mercury, 479 

Mercury, Biniodide of. 485 

Mercury poisoning, Acute, 
482 

Mercury poisoning, Chronic, 
483 

Mercury poisoning, treat- 
ment of, 482 

Mercury, Protoiodide of, 485 j 



Mercury, specific action in 
Syphilis, 481 

Mercury with chalk, 105 

Mergal, 487 

Mesotan, 501 

Metachloral, 409 

Metacresol, 577 

Metals, 547 

Methacetine, 450 

Method of administering 
vapors, 12 

Method of peptonizing milk, 
86 

Methylal, 419 

Methyl alcohol, 246 

Methylarbutin, 338 

Methyl Codeine Bromide, 434 

Methylene bichloride, 395 

Methylene blue, 604, 344 

Methylis Salicylas, 499 

Methyl salicylate, 499 

Methylthioninae hydrochlo- 
ridum, 604 

Metric equivalents of Apoth- 
ecaries units, 19 

Metric system, 16 

Metric table of Capacity, 17 

Metric table of Length, 16 

Metric table of Volume, 17 

Metric table of Weight, 17 

Mezereum, 292 

Migrainin, 451 

Mild Mercurous chloride, 
484, 103, 343, 516 

Milk and lime, 536 

Milk and molasses enema, 
126 

Milk foods, 299 

Milk of Magnesia, 537 

Milk sugar, 98, 627 

Milk weed, 173 

Milligramme, 17 

Mineral acids, 520, 59 

Mineral astringents, 547, 59 

Minimum dose of a drug, 13 

Mistura Bismuthi, 565 

Mistura Cretae, 536 

Mistura Ferri Composita, 136 

Mistura Glycyrrhizae Com- 
positus, 433, 613 

Mistura Rhei et Sodae, 106 

Misturae, 2 

Mitigated caustic, 555 

Mitigated Silver nitrate, 555 

Mixtures, 5, 2 

Moccasin plant, 459 

Mode of action of Nervous 
system, 225 

Molasses, 98 

Monk's hood, 345 

Monobromated Camphor, 
377, 178 

Monotal, 599 

Monoglycol salicylate, 502 

Monohydrated Sodium car- 
bonate, 530 

Monsell's solution, 134 

Morphine, 421, 433, 419, 467, 
364 

Morphine, action of, 423 

Morphine, Appearance of pa- 
tient, 422 



Morphine, Compound pow- 
der of, 434 
Morphine habit, 429 
Morphine hydrochloride, 434 
Morphine, Idiosyncrasies of, 
426 

Morphine meconate, 434 

Morphine poisoning, Acute, 
426 

Morphine poisoning, Chronic, 
429 

Morphine poisoning, treat- 
ment of, 428 

Morphine Scopolamine an- 
aesthesia, 264 

Morphine sulphate, 434 

Morphine, summary of ef- 
fects, 425 

Morphine, uses of, 430 

Moschus, 456, 185 

Motor depressants, 460 

Motor depression, effects of, 
231 

Motor stimulants, 310 

Motor stimulation, effects of, 
228 

Moulded Silver nitrate, 555 

Movements of the bowels, 
mode of action, 96 

Mucilage of Acacia, 612 

Mucilages, 5 

Muriated tincture of Iron, 
136 

Muriatic acid (Hydrochloric 
acid), 520 

Murphy saline, method of 
administration, 130 

Muscarine, 308 

Muscular sense, mode of ac- 
tion, 218 

Musk, 456, 185 

Mustard, 92, 609 

Mustard bath, 93 

Mustard, methods of applica- 
tion, 93 

Mustard paste, 93 

Mydriatics, 65 

Myocardial insufficiency, 164 

Myotics, 65 

Myristica, 81 

Myrosin, 93 

Myrrh, 607 

Myrrha. 607 

N 

Naphthalene, 596 
Naphthol, 501, 516 
Naphthol salicylate. 502, 596 
Narcotics (Hypnotics), 405, 

65, 56 
Narcotine, 435, 422 
National Formulary, 6 
Neosalvarsan, 494, 148 
Neriura, 158 
Nerve endings, depression of, 

232 
Nerve endings, stimulation 

of, 230 
Nerves, action of, 224 
Nerves, afferent, 224 



638 



INDEX 



Nerves, efferent, 224 

Nerves, stimulation of, 230 

Nervous system, mode of ac- 
tion, 225 

Neurasthenia, 453 

Neurodine, 450 

Neuro Lecithin, 303 

Neuronal, 419 

New Tuberculin, 624 

Nicotine, 465 

914 (Neosalvarsan) , 494, 148 

Nitrate of Silver, 555 

Nitrates, 342 

Nitric acid, 521, 517, 611 

Nitric acid poisoning, 518 

Nitric acid poisoning, treat- 
ment of, 519 

Nitrites, 354 

Nitroglycerin, 357 

Nitroglycerin, Appearance of 
patient, 358 

Nitroglycerin, cumulative 
symptoms, 360 

Nitroglycerin, poisonous ef- 
fects, 359 

Nitrohydrochloric acid, 521 

Nitrohydrochloric acid poi- 
soning, 518 

Nitrous oxide anaesthesia, 
396 

Nitrous oxide gas, 396 

Nitrous oxide gas, adminis- 
tration of, 398 

Nitrous oxide gas, Appear- 
ance of patient, 396 

Nitrous oxide poisoning, 397 

Normal horse serum, 624 

Normal salt solution, 128 

Novargan, 557 

Novaspirin, 501 

Novatophan, 506 

Novocaine, 402 

Novocaine nitrate, 402 

Nuclein, 624 

Nutgall, 542, 538 

Nutgall ointment, 543 

Nutmeg, 81 

Nutritive enemata, 126 

Nutrose, 298 

Nux Vomica, 273, 72 

Nux Vomica, Extract of, 279 

Nux Vomica poisoning, 276 

Nux Vomica, Tincture of, 279 



Oak gall, 538, 542 

Oenanthotoxin, 280 

Official preparations, 5 

Oil, Castor, 101 

Oil, Croton, 124 

Oil, fixed, 101, 124 

Oil of Cajuput, 80 

Oil of Cloves, 80 

Oil of Copaiba, 602 

Oil of Erygeron, 603 

Oil of Eucalyptus, 598 

Oil of Juniper, 336 

Oil of Pennyroyal, 329 

Oil of Peppermint, 78 

Oil of Sandalwood, 602, 344 



Oil of Sweet birch, 499 
Oil of Turpentine, 338, 609 
Oil of Vitriol, 521 
Oil of Wintergreen, 498 
Oil, volatile, 76, 70 
Ointment of Belladonna, 256 
Ointment of Boric acid, 595 
Ointment of Chrysarobin, 607 
Ointment, Diachylon, 552 
Ointment of Mercury, 485 
Ointment of Red oxide of 

Mercury, 486 
Ointment of Yellow oxide of 

Mercury, 485 
Ointments, 3, 9 
Old tuberculin, 623 
Oleander, 158 
Oleate of Atropine, 257 
Oleates, 5 

Oleoresin of Aspidium, 509 
Oleoresins, 5 
Oleum Betulae, 499 
Oleum Camphorae, 179 
Oleum Eucalypti, 598 
Oleum Gaultheriae, 498 
Oleum Gossypii seminis, 616 
Oleum Hedeomae, 329 
Oleum Lavandulae foliorum, 

80 
Oleum Lini, 616 
Oleum Menthae piperitae, 78 
Oleum Morrhuae, 301 
Oleum Olivae, 100, 616 
Oleum Ricini, 101 
Oleum Santali, 602, 344 
Oleum Terebenthinae, 338, 

344 
Oleum Theobromatis, 616 
Oleum Tiglii, 124 
Olive oil, 100, 616 
Opium, 421, 419, 364 
Opium, action of, 423 
Opium, active principles of, 

422 
Opium, alkaloids of, 422 
Opium, Camphorated tinc- 
ture of, 432 
Opium habit, 429 
Opium, Idiosyncrasies of, 426 
Opium, Pills of, 431 
Opium poisoning, 426 
Opium poisoning, treatment 

of, 428 
Opium, summary of effects, 

425 
Opium, Tincture of, 432 
Opsonins, 622 
Ordeal bean, 310 
Orexin, 72 

Organic acids, 522, 517 
Organic Iron preparations, 

138, 134 
Organic remedies, 625, 186 
Organic Silver preparations, 

555 
Orthocresol, 577 
Orthoform, 403 
Orthoform, New, 403 
Osmosis, 528 
Ouabain, 169 
Ounce, 18 
Ovarian extract, 626 



Overdose of a drug, 13 

Overstimulation, effects of, 53 

Overstimulation of Nervous 
system, effect of, 230 

Ovoferrin, 138 

Oxalic acid, 526 

Oxalic acid poisoning, 526 

Oxalic acid poisoning, treat- 
ment of, 526 

Oxaphor, 369 

Ox gall, 99 

Ox gall enema, 126 

Oxycamphor, 369 

Oxygen, 197 

Oxygen bath salts, 590 

Oxygen, use of in Pneu- 
monia, 198 

Oxyntin, 520 

Oxytocics, 314, 65 



Panama bark, 203 
Panase, 87 
Pancreatin, 85 
Pancreatized milk toast, 300 
Pankreon, 87 
Panopepton, 298 
Papain, 87 
Papaverine, 422 
Papaver somniferum, 421 
Papayotin, 87 
Papers, 4, 2 
Papoid, 87 
Paracresol, 577 
Paraffin, 615 
Paraform, 569 
Paraformaldehyde, 569 
Paraguay tea, 153 
Paraldehyde, 410, 364 
Paramidophenol, 441 
Parasiticides (see Antiseptics 

and Anthelmintics) 
Paratophan, 506 
Paregoric, 432 
Pareira, 72 
Parillin, 290 
Passive immunity, 618 
Pearson's solution, 147 
Pegnin, 85 
Pelletierine, 510 
Pellotine hydrochloride, 419 
Pental, 395 
Pennyroyal, 329 
Pepo, 511 
Pepper, 76 
Peppermint, 78 
Peppermint spirits, 78 
Peppermint water, 78 
Pepsin, 84 

Peptonized beef tea, 300 
Peptonized milk gruels, 300 
Peptonized milk toast, 300 
Peptonized oysters, 300 
Peptonizing powder, 86 
Peristaltic hormone, Zuelzer, 

110 
Perogen bath salts, 590 
Peronine, 435 
Peroxide of Hydrogen, 588 
Peruvian bark, 471 



INDEX 



639 



Petrolatum, 615 

Petrolatum album, 615 

Petrolatum liquidum, 615 

Pharmacodynamics, 1 

Pharmacognosy, 1 

Pharmacology, 1 

Pharmacopoeia, 5 

Phenacetine, 447, 467 

Phenacetine poisoning, 448 

Phenacetine urethane, 448 

Phenoco, 587 

Phenocoll, 449 

Phenocoll hydrochloride, 450 

Phenocoll salicylate, 450, 502 

Phenol, 573 

Phenol poisoning, 574 

Phenolphthalein, 109 

Phenylis salicylas, 499 

Phenyl salicylate, 499 

Phloridzin, 479 

Phosphorated oil, 286 

Phosphoric acid, 287 

Phosphorous, 281 

Phosphorous poisoning, 
Acute, 283 

Phosphorous poisoning, 
Chronic, 285 

Phosphorous poisoning, treat- 
ment of, 285 

Physiological salt solution, 
129 

Physostigma, 310 

Physostigmine, 310 

Physostigmine poisoning, 312 

Physostigmine salicylate, 313 

Physostigmine sulphate, 313 

Phytolacca, 281 

Phytolaccotoxin, 280, 281 

Picric acid, 593 

Picropodophylin, 120 

Picrotoxin, 280 

Pill, Compound cathartic, 123 

Pill, Lapactic, 107 

Pill of Aloes and Iron, 107, 
135 

Pill of Aloes and Mastiche, 
107 

Pill of Aloes and Myrrh, 107 

Pill of Iron carbonate, 134 

Pill of Iron iodide, 135 

Pill of Opium, 431 

Pill of Podophylum Bella- 
donna and Capsicum, 
121 

Pills, 2 

Pill, Vegetable cathartic, 123 

Pilocarpine, 304, 353 

Pilocarpine, Appearance of 
patient, 304 

Pilocarpine hydrochloride, 
308, 353 

Pilocarpine poisoning, 307 

Pilocarpine poisoning, treat- 
ment of, 307 

Pilocarpus, 304 

Pilulae Catharticae Com- 
positae, 123 

Pilulae Catharticae Vegeta- 
bilis, 123 

Pilulae Ferri iodidi, 135 

Pilulae Ferri jodatum (io- 
didi), 135 



Pilulae Laxativae Com- 

positae, 107 
Pimenta, 81 
Pink root, 513 
Pin point pupils, 428 
Pine tree, 209, 336 
Pinus palustris, 209, 336 
Piperazine, 505, 343 
Piperazine quinnate, 505 
Pipsissewa, 339 
Pituitary body, dessicated, 

627 
Pituitary extracts, 324, 325, 

626 
Pituitrin, 325, 626 
Pix liquida, 209 
Plasmine, 614 
Plaster, adhesive, 552 
Plaster, Belladonna, 256 
Plaster, Cantharides, 610 
Plaster, Capsicum, 609, 77 
Plaster of Paris, 617 
Plasters, 3 
Pleasant emotions, nature of, 

221 
Plumbi acetas, 551 
Plumbism (Lead poisoning), 

549 
Plumbum, 547 
Pluto water, 116 
Pneumococcus vaccine, 622 
Podophylotoxin, 120 
Podophylum, 120 
Poisoning by Alkalies, 532 
Poison mushrooms, 308 
Poison nut, 273 
Poisonous dose of a drug, 13 
Poke (Phytolacca), 281, 280 
Poke root, 280 
Polyvalent Antistreptococcus 

serum, 619 
Pomegranate, 510 
Porter, 245 
Port wine, 245 
Potash, 531 
Potash and lime, 532 
Potassa cum Calce, 532 
Potassium acetate, 340 
Potassium and Sodium tar- 

tarate, 113 
Potassium bicarbonate, 532 
Potassium bitartarate, 113, 

341 
Potassium bromide, 377, 371 
Potassium carbonate, 532 
Potassium chlorate, 605 
Potassium chlorate poisoning, 

605 
Potassium chlorate poisoning, 

treatment of, 606 
Potassium citrate, 341, 309 
Potassium cyanide, 368 
Potassium hydroxide, 531, 

611 
Potassium hypophosphite, 

287 
Potassium iodide, 492 
Potassium iodide ointment, 

492 
Potassium nitrate, 343 
Potassium nitrite, 363 
Potassium oxalate, 526 



Potassium permanganate, 

590, 140 
Potassium salts, 113, 531 
Potassium sulphate, 113 
Potato fly, 610 
Powdered Ipecac, 90 
Powdered Ipecac and Opium, 

90 
Powdered Opium, 431 
Powders, 2, 8 

Predigested liquid food, 299 
Preparations for anaesthesia, 

385 
Preparations of Fats, 301 
Prepared lard, 615 
Prescription reading, 24 
Pride of China, 514 
Propaesin, 404 
Prophylactics, 65 
Propyl Alcohol, 246 
Protan, 541 
Protargol, 556 
Protectives, 617 
Proteid preparations, 296 
Protein silver salt, 556 
Protoiodide of Mercury, 485 
Protoveratrine, 349 
Prunus Virginiana, 73, 214 
Prussic acid, 365, 353, 527 
Pulvis, 2 
Pulvis Acetanilidi Composi- 

tus, 447 
Pulvis Aromaticus, 81 
Pulvis Effervescens Composi- 

tus, 115 
Pulvis Glycyrrhizae Composi- 

tus, 109 
Pulvis Ipecacuanhae, 90 
Pulvis Ipecacuanhae et Opii, 

431 
Pulvis Morphinae Composi- 

tus, 434 
Pulvis Pancreaticus Com- 

positus, 86 
Pumpkin seeds, 511 
Purgatives, 98, 101, 65 
Purgatives, Drastic, 117 
Purgatives, Saline, 111 
Purgatives, Vegetable, 101 
Purified extract of Ergot, 320 
Purple foxglove, 158 
Pu8tulants, 61 
Pyramidon, 449, 467 
Pyramidon acid camphorate, 

449 
Pyramidon neutral campho- 

rate, 449 
Pyridine, 465 
Pyrocatechin, 586 
Pyrogallic acid, 586 
Pyrogallol, 5S6 



Quaker buttons, 273 
Quassia, 71, 515 
Quassin, 71 
Quebracho, 195 
Queen's delight. 293 
Quercus, 546 
Quevenne's iron, 135 



640 



INDEX 



Quicklime, 536 
Quicksilver, 479 
Quillaja, 203 
Quinidine, 471 
Quinine, 471, 477, 325 
Quinine, action of, 472 
Quinine, administration of, 

476 
Quinine and Urea hydrochlo- 
ride, 478 
Quinine bisulphate, 477 
Quinine ethyl carbonate, 478 
Quinine hydrobromide, 477 
Quinine hydrochloride, 477 
Quinine, Idiosyncrasies of, 

475 
Quinine lygosinate, 478 
Quinine poisoning, 475 
Quinine, specific action in 

Malaria, 473 
Quinine sulphate, 477 
Quinine tannate, 478 
Quinolin Bismuth sulphocy- 
anate, 566 



Rabies Antitoxin (Antirabic 
Vaccine), 624 

Reasoning power of the brain, 
mode of action, 220 

Rectoclysis, 130 

Red corpuscles of the blood, 
function of, 127 

Red iodide of Mercury, 485 

Red rose petals, 79, 546 

Reduced iron, 135 

Red wines, 244 

Refined Diphtheria Anti- 
toxin, 621 

Reflex action, nature of, 223, 
225 

Refrigerants, 65 

Regulin, 110 

Resin of Podophylum, 121 

Resins, 3 

Resorcin, 585 

Resorcin monacetate, 586 

Resorcinol, 586 

Respiration, mechanism of, 
192 

Respiratory center of Medul- 
la, action of, 223 

Respiratory depressants, 364, 
65 

Respiratory stimulants, 195, 
65 

Respiratory stimulation, ef- 
fects of, 195 

Revulsants, 65 

Rhamnus purshianae, 99 

Rhatany, 544 

Rheum, 105 

Rhubarb, 105 

Rhubarb and Soda mixture, 
106 

Rhus glabra, 546 

Ringer's solution, 129 

Rochelle salt, 113 

Rosa gallica petalae, 79, 546 

Rosemary, 79 



Rose ointment, 547 

Rose water, 547 

Round worms, 507 

Rubbings, 11 

Rubefacients, 608, 60, 65 

Rubus, 545 

Rue, 327 

Rule for administering doses 
of drugs from a limited 
number of stock tablets, 
41 

Rule for administering doses 
of drugs from stock solu- 
tions, 43 

Rule for administering doses 
of drugs greater than 
that contained in a drop 
of stock solution, 47 

Rule for administering doses 
of drugs less than that 
contained in a drop of 
stock solution, 45 

Rule for calculating the dose 
for a child, 14 

Rule for making solutions for 
external use from other 
solutions, 37 

Rule for making solutions for 
external use from pow- 
ders, 35 

Rule for making solutions for 
external use from tablets, 
34 

Rule for measuring doses of 
drugs from stock tablets, 
41 

Rule for reducing Apotheca- 
ries quantities to their 
Metric equivalents, 22 

Rule for reducing Metric 
quantities to their 
Apothecaries equiva- 
lents, 21 

Rules for making solutions, 
34 

Rum, 243 

Ruta, 327 



S 



Sabina, 325, 609 

Sabine poisoning, 326 

Sabromin, 378 

Saccharin, 627 

Saccharum lactis, 627, 98 

Sacred bark (Cascara sa- 
grada), 99 

Sajodin, 492 

Sal Carolinum, 114 

Sal Carolinum factitium, 
114 

Saleratus (Potassium bicar- 
bonate), 532 

Sal Ethyl, 501 

Salicylates, 494 

Salicylates, comparative ac- 
tion of, 500 

Salicylates, poisonous effects, 
497 

Salicylates, specific action in 
Rheumatism, 496 



Salicylic acid, 494, 498 

Salicylic acid ointment, 501 

Saliformin, 604 

Saliphen, 450, 502 

Salipyrin, 444 

Saline purgatives, 111, 101, 
65 

Saline purgatives, mode of ac- 
tion, 111 

Salines (salts), 528, 111 

Salocoll, 450 

Salol, 499 

Salophen, 450, 501 

Saloquinine, 478, 501 

Saloquinine salicylate, 478, 
502 

Salt, 95 

Salt, acid radicle of, 371 

Salt action, 371, 528 

Salt, base of, 371 

Salt, Carlsbad, 114 

Salt, Epsom, 114 

Salt, Glauber, 113 

Salt, Rochelle, 113 

Salts of Magnesium, 114 

Salts of Potassium, 113 

Salts of Sodium, 113 

Saltpeter, 343 

Salvarsan, 493, 148 

Sanatogen, 297 

Sandal wood oil, 602 

Santonica, 512 

Santonin, 512 

Sanguinaria, 212, 436 

Saponins, 201, 203, 290 

Sapotoxins, 204 

Sarsaparilla, 290 

Sarsaparilla, Compound syr- 
up of, 291 

Sarsaponin, 290 

Sassafras, 292, 81 

Sassafras medulla, 613 

Saturated solution, 31 

Saturation points of solutions 
for external use, 32 

Saturation points of solutions 
for internal use, 33 

Saturation points of solu- 
tions, table of, 31 

Savine, 325 

Scammonium, 118 

Scammony, 118 

Scarlet R, 607 

Schleich's solution, 400 

Scilla, 169 

Scoparin, 334 

Scoparius, 334 

Scopola, 265, 248 

Scopolamine, 263 

Scopolamine hydrobromide, 
264 

Sea onion, 169 

Seat worms, 507 

Secretory depressants, 468 

Secretory stimulants, 304 

Sedative Expectorants, 369 

Sedatives, 65 

Seidlitz powder, 115 

Senega, 201 

Senegin, 201 

Senna, 108, 515 

Senna tea, 108 



INDEX 



641 



Sense of hearing, mode of ac- 
tion, 217 

Sense of pain, mode of action, 
218 

Sense of sight, mode of action, 
218 

Sense of smell, mode of action, 
217 

Sense of taste, mode of ac- 
tion, 217 

Sense of temperature, mode of 
action, 218 

Sense of touch, mode of ac- 
tion, 217 

Sera (serums), 618, 61 

Serums, 618, 61 

Serums, method of manufac- 
ture, 618 

Serpentaria, 73 

Sevum praeparatum, 615 

Sherry, 244 

Sialogogues, 65 

Sidonal, 505 

Signature of a prescription, 24 

Silver, 552 

Silver Casein, 557 

Silver ichthyolate, 557 

Silver lactate, 557 

Silver nitrate, 555, 611 

Silver nitrate Ammonia al- 
bumose, 557 

Silver nitrate poisoning, 553 

Silver oxide, 555 

Silver poisoning, 553 

Silver viteliin, 556 

Simple bitters, 70 

Sinalbin, 92 

Sinapis, 92 

Sinapis alba, 92 

Sinapis nigra, 92 

Sinigrin, 93 

606 (Salvarsan), 493, 148 

Skull cap, 459 

Slaked lime, 536 

Slippery elm, 612 

Smilacin, 290 

Smilax, 290 

Snake root, 201 

Soamin, 148 

Soap bark, 203 

Soap liniment, 179 

Soap plaster, 552 

Soda, 530 

Sodium acetate, 341 

Sodium arsenate, 147 

Sodium benzoate, 600 

Sodium bicarbonate, 530 

Sodium borate, 595 

Sodium bromide, 375, 377 

Sodium cacodylate, 148 

Sodium carbonate, 530 

Sodium chlorate, 606 

Sodium chloride, 95, 515 

Sodium compounds, 529 

Sodium Diethyl Barbiturate, 
417 

Sodium hydroxide, 530, 611 

Sodium hypophosphite, 287 

Sodium ichthyol, 584 

Sodium iodide, 492 

Sodium nitrate, 343 

Sodium nitrite, 363 



Sodium perborate, 590 

Sodium peroxide, 589 

Sodium phosphate, 113 

Sodium salicylate, 498 

Sodium sulphate, 113 

Solid preparations, 2 

Solution of Ammonia and 
Anise, 201 

Solution of Ammonium ace- 
tate, 309 

Solution of Arsenic and Mer- 
curous iodide, 147, 4S5 

Solution of Calcium hydrate, 
535 

Solution of Chlorinated Soda, 
572 

Solution of Formaldehyde, 
568 

Solution of Hydrogen perox- 
ide, 588 

Solution of Iron and Ammo- 
nium acetate, 136 

Solution of Lead subacetate, 
552 

Solution of Magnesium cit- 
rate, 115 

Solution of Potassium arsen- 
ite, 147 

Solution of Potassium citrate, 
341 

Solution of Sodium hydrox- 
ide, 530 

Solution of Zinc chloride, 562 

Solutions, 31, 4 

Solutions, rules for making, 
34 

Solutions, saturated, table of, 
32 

Solutol, 578 

Solved, 578 

Somatose, 297 

Somnifacients, 405, 65 

Somnoforra, 396 

Sophol, 557 

Soporifics, 405, 65 

Source of drugs, 1 

Sozal, 592 

Sozoiodol, 592 

Spanish fly, 609 

Sparkling Burgundy, 245 

Sparkling white wines, 244 

Sparteine, 463, 334 

Sparteine sulphate, 464 

Spearmint, 78 

Specifics, 471, 65, 57 

Specifics for Gout, 502, 505, 
58 

Specifics for Malaria, 471, 
57 

Specifics for Rheumatism, 
494, 58 

Specifics for Syphilis, 479, 
487, 493, 57 

Speech impulses of the brain, 
219 

Spermacetti, 616 

Sphacelotoxin, 314, 316 

Spigelia, 513 

Spinal anaesthesia, 404 

Spinal cord, action of, 223 

Spinal cord, effect of depres- 
sion of, 232 



Spinal cord, effect of stimu- 
lation of, 230 

Spirits, 5 

Spirits of Camphor, 176 

Spirits of Chloroform, 392 

Spirits of Ether, 386 

Spirits of Glonoin, 357, 361 

Spirits of Glyceryl trinitrite, 
357, 361 

Spirits of Mindererus, 1S3, 
309 

Spirits of Nitroglycerin, 361 

Spirits of Nitrous ether, 361, 
309, 344, 387 

Spiritus Aetheris nitrosi, 361, 
309, 344, 387 

Spiritus Frumenti, 242 

Spiritus Glycerylis nitratis, 
361 

Spiritus Menthae piperitae, 
78 

Spiritus Rosemarini, 79 

Spotted hemlock, 402 

Squibb's diarrhoea mixture, 
433 

Squills. 169, 331, 214 

Squirting cucumber, 122 

Staphisagria, 349 

Staphylococcus vaccine, 622 

Starch, 014 

Starch enema, 126 

Starch sugar, 300 

Stavesacre, 349 

Stearoptene, 176 

Sterules, 3 

Stilligia, 293 

Stimulants, 54 

Stimulating expectorants, 198 

Stimulation, 53 

Stimulation of blood forming 
organs, effects of, 12S 

Stimulation of Medulla ob- 
longata, effects of, 22!) 

Stimulation of motor areas of 
brain, effects of, 228 

Stimulation of speech center 
of brain, effects of, 228 

Stock vaccines, 621 

Stomachics, 66 

Storax, 601 

Stout, 245 

Stovaine, 403, 273 

Stramonium, 258 

Stramonium poisoning, 259 

Streptococcus vaccine, 622 

Strontium bromide, 376 

Strontium iodide, 492 

Strontium lactate, 312 

Strontium peroxide, 589 

Strophamin, 169 

Strophantus, 167 

Strychnine, 273, 184 

Strychnine, Appearance of 
patient, 274 

Strychnine, cumulative ac- 
tion. 27S 

Strychnine poisoning. Acute, 
276 

Strychnine poisoning, Chron- 
ic. 278 

Strychnine poidoning, treat- 
ment of, 277 



642 



INDEX 



Strychnine sulphate, 279 

Styptic collodion, 617, 540 

Stypticin, 324 

Styptics, 66 

Styptol, 324 

Styracol, 599 

Styrax, 601 

Subconscious actions, nature 

of, 224 
Sublamine, 579 
Sublimed sulphur, 100 
Subnitrate of Bismuth, 565 
Succinic dioxide, 590 
Sudden Chloroform death, 

390 
Sudorifics, 66 
Suet, 615 
Sugar of lead, 551 
Sugar of milk, 98, 627 
Sulphaminol, 592 
Sulphonal, 412, 364 
Sulphonal, cumulative symp- 
toms, 413 
Sulphonal poisoning, 413 
Sulphur, 100, 582 
Sulphur dioxide, 570 
Sulphuric acid, dilute, 521, 

517 
Sulphuric acid poisoning, 519 
Sulphur iodide, 582 
Sulphur ointment, 583 
Sulphur sublimatum, 100 
Sumach, 546 
Superscription, 24 
Suppositories, 4, 9 
Supracapsulin, 190 
Suprarenalin, 190 
Suprarenin, 190 
Sweet almonds, 614 
Sweet orange peel, 79 
Sweet red wines, 245 
Sweet spirit of Niter, 361, 

309, 344, 387 
Sweet wines, 244 
Syphilis, 481 
Syrup of Calcium hydroxide, 

536 
Syrup of Hydriodic acid, 492 
Syrup of Iodide of Iron, 136 
Syrup of Ipecac, 90 
Syrup of Iron, Quinine and 

Strychnine phosphate, 

137, 279, 477 
Syrup of lime, 536 
Syrup of Rhubarb, 106 
Syrup of Senega, 203 
Syrup of Squills, 171 
Syrup of tar, 211 
Syrup of Tolu, 209 
Syrup of wild cherry, 365 
Syrups, 5 

Syrupus Calcis, 536 
Syrupus Ferri jodatum (io- 

didi), 136 
Syrupus Hypophosphitum, 

287 
Syrupus Hypophosphitum 

Compositus, 287 
Syrupus Pruni Virginianae, 

73, 365 
Syrupus Tolutanus, 209 
Systems of Measurement, 16 



Tabacum, 465 

Tabellae Trinitri, 361 

Table of Apothecaries equiv- 
alents of Metric units, 19 

Table of Apothecaries fluid 
measurement, 18 

Table of Apothecaries 
Weights, 18 

Table of Approximate Metric 
units used in prescrip- 
tions, 20 

Table of Cardiac Stimulants, 
191 

Table of Comparative action 
of Antipyretics, 452 

Table of Comparative action 
of Atropine group, 267 

Table of Comparative action 
of Digitalis group, 175 

Table of Comparative action 
of Salicylates, 500 

Table of Metric lengths, 16 

Table of Metric volumes, 17 

Table of Metric weights, 17 

Table of Usual strengths of 
solutions for external use, 
50 

Table of Usual strengths of 
solutions for internal use, 
52 

Tablets, 3 

Taeniae, 507 

Taenicides, 508, 66 

Taka diastase, 84 

Tamarind, 100 

Tamar Indien (Confection of 
Senna), 108 

Tanacetum, 327 

Tannacol, 541 

Tannalbin, 541 

Tannic acid, 538, 515 

Tannic acid ointment, 540 

Tannigen, 541 

Tannin albuminate, 541 

Tanninformaldehydum, 541 

Tannin nucleo proteid, 541 

Tannismuth, 566 

Tannoform, 541 

Tannopin, 541 

Tannon, 541 

Tannyl acetate, 541 

Tansy, 327 

Tansy poisoning, 328 

Tape worms, 507 

Tar, 209 

Taraxacin, 335 

Taraxacum, 335 

Tartar emetic, 94 

Tartaric acid, 525 

Tea, 153 

Tea plant, 547 

Temperature, mode of pro- 
duction, 439 

Temperature, mechanism of 
reduction, 440 

Temperature, Mechanism of 
regulation, 439 

Terebene, 205 

Terebenum, 205 

Terebinthina, 336 



Terpin hydrate, 206 

Terpini hydras, 207 

Tetanus Antitoxin, 621 

Tetranitrol, 363 

Tetronal, 415, 364 

Thallein acetate, 469 

Thalline, 450 

Thebaine, 422 

Theobroma, 332 

Theobromine, 332 

Theobromine and Lithium 
benzoate, 333 

Theobromine and Lithium 
salicylate, 333 

Theobromine Sodium acetate, 
333 

Theobromine Sodium sali- 
cylate, 333 

Theocin, 334 

Theophylin, 334 

Theophylin Sodium acetate, 
334 

Thermodin, 448 

Thiersch powder, 501 

Thiersch solution, 499, 588 

Thilanin, 583 

Thioform, 593 

Thiol, 584 

Thiolum, 584 

Thiophene, 592 

Thiosinamine, 294 

Thiosinamine Sodium sali- 
cylate, 295 

Thorn apple, 258 

Thoroughwort, 308 

Thread worms, 507 

Thujon, 176 

Thymacetine, 450 

Thymol, 597, 515 

Thymolis iodidum, 592 

Thymosalol, 502 

Thymus, 627 

Thyroid extract, 625 

Thyroid gland, 625 

Tinctura Benzoini Com- 
positus, 601 

Tinctura Cinchonae Com- 
posita, 477 

Tincture of Aconite, 348, 399 

Tincture of Arnica, 353 

Tincture of Belladonna, 256 

Tincture of Benzoin, 601 

Tincture of Benzoin, Com- 
pound, 601 

Tincture of Cannabis Indica, 
438 

Tincture of Cantharides, 610 

Tincture of Cinchona, 477 

Tincture of Cinchona, Com- 
pound. 477 

Tincture of Deodorized Opi- 
um, 432 

Tincture of Digitalis, 166 

Tincture of Guiac, 291 

Tincture of Hyoscyamus, 262 

Tincture of Iodine, 582 

Tincture of Iron chloride, 136 

Tincture of Myrrh, 607 

Tincture of Nux Vomica, 279 

Tincture of Opium, 432 

Tincture of Opium, Cam- 
phorated, 432 



INDEX 



643 



Tincture of Valerian, 454 

Tobacco, 465 

Tobacco camphor, 465 

Tonics, 128, 66 

Toxiresin, 280 

Tragacanth, 612 

Transfusion, 130 

Treatment of Atropine poi- 
soning, 254 

Treatment of Carbolic acid 
poisoning, 575 

Treatment of Hydrocyanic 
acid poisoning, 367 

Treatment of Opium poison- 
ing, 430 

Treatment of poisoning by 
acids, 519 

Treatment of poisoning by 
alkalies, 533 

Trichloracetic acid, 524, 611 

Tricresol, 577 

Trinitrin (Nitroglycerin), 361 

Trional, 414, 364 

Trioxymethylene, 569 

Triphenin, 449 

Triticum, 339 

Troches (Lozenges), 2, 3 

Trochisci, 2 

Tropacocaine, 401, 273 

Tropacocaine hydrochloride, 
401 

Tropical fruit laxative (Con- 
fection of Senna), 108 

Trypsin, 84, 87 

Tuberculin, 623 

Tuberculin, New, 624 

Tuberculin, Old, 623 

Tully's powder, 434 

Tumenol, 585 

Tumenol Ammonium, 585 

Tumenol Venale, 585 

Turlington's balsam, 601 

Turpentine, 336, oil, 214 

Turpentine liniment, 338 

Turpentine oil, 388, 344 

Turpentine stupe, 337 

Turpeth mineral, 95 

Tussol, 459 

Typhoid vaccine, 622 

Tyramine, 325 



U 



Ulmus, 612 

Uncinaria Americana, 515 

Uncinariae, 507 

Unguentum, 2 

Unguentum Acidi Borici, 595 

Unguentum Aqua Rosae, 

79 
Unguentum Crede, 556 
Unguentum Diachylon, 552 
Unguentum Gallae cum Opii, 

543 
Unguentum Hydrargyri, 485 
Unguentum Hydrargyri am- 

moniati, 486 
Unguentum Hydrargyri ni- 

tatis, 486 
Unguentum Hydrargyri oxidi 

flavi, 485 



Unguentum Hydrargyri oxidi 

rubri, 486 
Unguentum Iodi, 582 
Unguentum Iodoformi, 592 
Unguentum Sulphuris, 583 
Unguentum Veratrinae, 352 
United States Dispensatory, 6 
Unofficial preparations, 6 
Unslaked lime, 536 
Upas tree, 158 
Urari, 466 
Urethane, 415 
Urinary Antiseptics, 600 
Urophen B, 333 
Urophen S, 333 
Urotropine, 603, 344 
Uterine Depressants, 467 
Uterine Sedatives, 467 
Uterine Stimulants, 314 
Uva Ursi, 338 



Vaccines, 621 

Vaccines, Bacterial, 621 

Vaccine virus, 624 

Vagus center of the Medulla, 
223 

Vagus center, stimulation of, 
229 

Valentine's meat juice, 297 

Valerian, 453 

Validol, 454 

Validol camphorate, 454 

Valyl, 454 

Vanilla, 81 

Vascular depressants, 354, 
345, 55 

Vascular sedatives, 354, 345, 
55 

Vascular stimulants, 186, 55 

Vaseline, 615 

Vaso dilators, 354 

Vaso-motor center of the 
Medulla, 223 

Vegetable acids, 522, 59 

Vegetable astringents, 538, 59 

Vegetable cathartic pill, 123 

Vegetable cathartics, 101 

Vegetable diuretics, 334 

Vegetable purgatives, 101 

Vegetable substances con- 
taining Gallic acid, 542 

Vegetable substances contain- 
ing Tannic acid, 542 

Vehicle of a prescription, 24 

Veratrine, 349, 351, 399 

Veratrine ointment, 352 

Veratrum, 349 

Veratrum poisoning, 351 

Veratrum sabadilla, 351 

Veratrum viride, 349, 309 

Vermicides 507, 66 

Vermifuges, 507, 66 

Veroform, 5S7 

Veronal, 416, 364 

Veronal Sodium, 417 

Vescettes, 3 

Vesicants, 609, 66 

Vesicating collodion (Can- 
tharides collodion), 610 



Vesicatories, 66 

Viburnum, 467 

Viburnum opulus, 467 

Viburnum prunifoliorum, 467 

Vienna paste, 532 

Vinegars, 523, 5, 515 

Vinum album, 244 

Vinum Colchici seminis, 505 

Vinum Portense, 245 

Vinum Rubrum, 244 

Vinum Xericum, 244 

Vioform, 592 

Volatile oils, 76, 70 

Vomiting center of the Me- 
dulla, 223 

Vomiting, mode of produc- 
tion, 88 



W 

Wahoo, 99 

Warburg's tincture, 477 

Washed sulphur, 100 

Washing soda, 530 

Water dropwort, 280 

Water hemlock, 280 

Waters, 4 

Weakened heart action, 164 

Whiskey, 242 

White agaric, 468 

White corpuscles of the blood, 

function of, 127 
White poppy, 421 
White precipitate (Ammo- 

niated Mercury) oint- 
ment, 486 
White turpentine, 336 
White vaseline, 615 
White wash, 536 
White wax, 616 
White wines, 244 
Wild cherry, 73, 214 
Wild cherry, Syrup of, 73, 

214 
Will power, mode of action, 

222 
Wine of Antimony, 94 
Wine of Coca, 272 
Wine of Colchicum seed, 

505 
Wine of Ipecac, 90 
Wines, 243, 5 
Wintergrecn, 80, 499 
Wintergreen oil. 498, 80 
Wistar's cough lozenge, 432 
Witch hazel, 544 
Wolfsbane, 345 
Wood alcohol, 246 
Wood alcohol poisoning, 246 
Wood alcohol poisoning, 

Chronic-, 246 
Wool fat. 616 
Woorali, 466 
Woorara, 466 



Xanthopsia, 512 
Xanthoxylum, 294 
Xeroform, 566, 593 



644 



INDEX 



Yellow iodide of mercury, 
485 

Yellow jasmine, 460 

Yellow Mercurous subsul- 
phate, 95 

Yellow oxide of mercury- 
ointment, 485 

Yellow root, 320 

Yellow vision, 512 

Yellow wash, 486 

Yellow wax, 616 



Yerba santa, 213 

Young's rule for Dosage, 14 



Zea, 339 

Zinc, 559 

Zinc acetate, 561 

Zinc bromide, 562 

Zinc carbonate, precipitated, 

561 
Zinc chloride, 561, 578 



Zinc iodide, 562 

Zinc oxide, 561 

Zinc oxide ointment, 561 

Zinc permanganate, 590 

Zinc peroxide, 589 

Zinc poisoning, 560 

Zinc poisoning, chronic, 561 

Zinc stearate, 561 

Zinc stearate ointment, 561 

Zinc sulphate, 561, 578, 95 

Zincum, 559 

Zinc valerate, 582 

Zingiber, 77 



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